Update: Safety Net Pool for OMH Article 31 Outpatient Clinics

March 13, 2023

Please review the email (below) that we first sent to all members on February 6.

Update: Some Article 31 Outpatient Clinic providers may be aware of a pending remittance (in the eMedNY system) that is labeled ‘Safety Net Pool’.  According to OMH this is related to a recent CMS SPA approval (discussed below in yellow highlight) that reduces the threshold to qualify to participate in the Article 31 Outpatient Clinic Safety Net Pool from the previous 5% threshold to a new and reduced 3% threshold.  I checked it out with OMH and can confirm that these funds are the result of the SPA approval for the Article 31 Outpatient Clinic (read more below).  More information from the state will be forthcoming.

From: Lauri Cole <lauri@nyscouncil.org>
Sent: Monday, February 6, 2023 12:40 PM
Subject: OMH Indigent Care / Safety Net Pools: Inside & Outside the ’24 Exec Budget Proposal

Good afternoon,

We continuing to analyze the executive budget proposal and wanted to share the following information: 

Recently (and outside of the executive budget process) CMS approved a Safety Net Pool State Plan Amendment (SPA) submitted by NYS that continues the federal match of resources for OMH Outpatient Clinic providers who meet eligibility standards for reimbursement through the Pool.  The approved SPA ‘rationalizes the methodology to allow more providers to participate’.   That being said, it is still FFS dependent and linked.  Note:  The recently approved Pool expands access to care by lowering the threshold to participate in the Pool from the current 5% threshold to 3% to qualify, thereby opening up participation to more OMH Outpatient Clinics.

The ’24 executive budget proposal also includes a provision that requires the state to seek approval from CMS for a separate Indigent Care Pool to assist qualifying CCBHCs (Demos) with reimbursement associated with provision of services to any care recipient.  In doing so, it acknowledges the CCBHC open access certification criteria that requires the CCBHC Demo Clinic to provide services to all care recipients regardless of ability to pay.  The proposed CCBHC indigent care pool would exclude CCBHCs from participating in other pools.