March 23, 2023
Important media coverage of two topics we have discussed recently, in today’s Albany Times Union – see articles linked at bottom of this email. The first article speaks to an issue we have been working with OASAS to resolve: A few months ago a group of NYS Council members met with OASAS leadership to discuss the consequences of bail reform and other policy decisions, on utilization of the OASAS Article 32 – Part 822 Outpatient Clinic. We had a frank conversation in which we reiterated our concerns for the sustained viability of the Clinic as well as all impacted programs and services, and we argued for OASAS to take responsibility for forecasting and being transparent regarding the anticipated consequences of such changes BEFORE implementing them, and then adding resources to ensure continued viability. We were not arguing for bail reform changes or service changes – we were stating that OASAS must understand the implications of policy changes such as bail reform, the addition of the Medication only service in the Clinic, on the sustainability of impacted services and provide resources to ensure continued viability before the change occurs.
OASAS responded by electing to use the MCO overpayments returned to the Office as result of NYS Council advocacy to compel the state to enforce certain MCO performance targets, for rate increases. As many of our members know, in addition to the Outpatient Clinic, for many years we have been leading advocacy efforts to address OASAS 820 fiscal and other issues, working with a group of upstate NY providers to compel the state to address fiscal holes in the model. The 820 rate changes are listed below.
Last month OASAS answered our question as to how the recoupment funds we worked to secure will be used. There is an additional $37M going back to OASAS for the 2023-2024 budget that is currently under negotiation.
As long as MCOs continue to miss their expenditure targets, the overpayments will be returned to OASAS and OMH as the result of NYS Council advocacy. To date, $37M has been returned to OASAS $74M with federal share.
Below please find the info we first shared last month with all members re: how OASAS will use these funds we compelled the state to return to the Offices.
Note: The changes discussed below are based on funds returned to OASAS in the 2022-2023 state budget. There is an additional $37M coming for the 2023-2024 budget period. Going forward, as long as MCOs continue to miss their expenditure targets, the overpayments will be returned to OASAS and OMH:
2022-2023 Rate Increases
– 5% trend on every Medicaid-able OASAS service except hospital inpatient (upon approval, retro to Jan 1, ’23)
– off-site rate code enhancement for freestanding outpatient and OTP (upon approval, retro to Jan 1. ’23)
– Peer service weight increases (upon approval, retro to Jan 1, ’23)
– Addiction Specific E&M APG weight increases (upon approval, retro to Jan 1, ’23)
– Part 820 Residential Rate Increases (upon approval, retro to March 1, ’23)
Breaking it down for the OASAS 820 (Public Notice announcing the changes has already been published):
- Rehab Level= 4.5% increase across the state
- Stabilization Level= 15% increase across the state, w/ 5.6% more for downstate
Articles mentioned above:
State data obtained by the Times Union show usage of drug courts has dropped nearly in half since sweeping changes were made in 2019 to the state’s bail and pre-trial discovery laws. Those changes to the criminal justice statutes have contributed to an unintended consequence: significantly fewer individuals are faced with choosing between incarceration or entering a drug court rehabilitation program. That drop in the number of individuals entering drug courts came after New York’s criminal justice statutes were overhauled three years ago. (TU)
A bill that would authorize “overdose prevention centers” was passed by the state Assembly’s health committee earlier this week, giving supporters of the legislation hope that the measure may gain more momentum with lawmakers than in prior years. (TU)