March 10, 2023
Yesterday morning members of the NYS Council gathered via Zoom for our weekly NYS Council Member Support and Public Policy Call. Trisha Schell-Guy from the Department of Health/Office of Health Insurance Programs zoomed in from Nashville where she is on vacation, to join the conversation.
During the meeting I referred to a number of documents relevant to the conversation we were having with Trisha regarding various Health/Medicaid executive budget proposals, including an administrative action the Department has indicated it will take to address some of the access to care issues facing New Yorkers trying to obtain care from community-based mental health, substance use / addiction, and primary care providers.
Attached please find the PowerPoint presentation I referenced that was used by state agency leads during a recent DoH Budget Briefing. Slide #37 discusses an administrative action the Department plans to take sometime after the new state budget is enacted, that would raise the thresholds providers must abide by when providing care in an area for which it does not have a license. For example, if a licensed mental health agency wants to offer primary care services but it does not have an Article 28 license, the provider would be held to providing no more than 30% primary care services (measured by Medicaid service volume / year). Currently, the threshold is 5%. Similarly, if an Article 28 D&TC wants to provide substance use disorder services but it does not have a license from OASAS to do so, it can provide up to 30% of these services (using the same measurement methodology). You will note on slide 37 that the Department also plans to convene an Integrated Care Workgroup where we will push for the group to resolve billing and rate issues associated with the provision of services as described here.
Also attached please find the 23-24 Medicaid Scorecard I mentioned at the top of the call. The Scorecard is a budget document that identifies all of the various Medicaid-related actions the executive is proposing in the executive budget proposal. The Scorecard lists the actions being taken in the area of Medicaid budget proposals, timeframe for when the proposal would be implemented, and how much the state will spend or save if the proposal is implemented as described. Slide #37 corresponds to an item on the scorecard labeled ‘Integrated Licensing’.
Each of the three proposals on slide #37 are being proposed as administrative actions meaning that the Department of Health intends to implement these changes under its administrative authority. As such, the proposals on the slide are not subject to acceptance/rejection by the legislature.
We hope you found the call yesterday to be informative. If you are not a regular participant in our weekly Thursday morning calls, consider joining your NYS Council member agency colleagues on these calls. It’s 45 minutes of your time and (as many NYS Council members have told me) they are well worth your time. The calls are from 9:15-10:00 on Thursday mornings. If you need a link to join the calls, contact Cindy Levernois at: email@example.com . Please do not share the link outside of your agency. These calls are for members only.