September 25, 2024

Please read this email in full and note that our Thursday morning call tomorrow morning is cancelled to give you time to respond to the very brief survey at the link (embedded below).

Good afternoon,

The NYS Council has been hearing from some of our members that are trying to engage with commercial insurers (in instances where the provider is currently not ‘in network’ with the plan/s) that insurers are stating they will not talk about extending in network status to the provider until such time as the Department of Financial Services (DFS oversees commercial plans in NYS) puts out written guidance to the insurers re: Part AA – the new commercial rate mandate.

There are other providers who are in network with a commercial plan/s that are trying to amend existing contracts with the commercial insurer to include some language in the contract that memorializes the major components of the new commercial rate mandate however only some of the plans are agreeing to amend the existing contract – presumably until the state puts out formal guidance on Part AA.

The NYS Council has been aggressively advocating with state officials for the Department of Financial Services in concert with OMH and OASAS to do far more than merely issue an FAQ document and host a webinar sometime in October to review the FAQs with impacted providers (this is the current plan).  In our opinion, FAQs do not suffice.  We have raised this concern with the Governor’s Office twice to date with another meeting coming up on Friday and we have been very urgent in our requests to OMH and OASAS for assistance to move DFS to take formal action by issuing a DFS Notice or Circular to the impacted health plans in NYS re: the new commercial mandate.  Unfortunately, in these instances some plans are telling providers they won’t do anything until they receive formal guidance from DFS re: the new mandate.

To help us quantify the extent of the problems our members are currently experiencing PLEASE share your responses to the following questions by end of business tomorrow (Thursday) so we can use this information (completely confidential and in the aggregate only) to advocate on your behalf beginning with representatives in the Governor’s office on Friday.  Please fill out the survey linked here:  https://www.surveymonkey.com/r/KHLYXB8

To give you the time to complete the survey we are asking that you use the time we ordinarily use for our Thursday morning call to complete the survey tomorrow and send it back to us as soon as possible but no later than end of business tomorrow.  So no call tomorrow morning.

We know this is short notice and we apologize for any inconvenience this causes.  THANK YOU for your responses in advance.