April 15, 2022
I have a few updates to the email I sent yesterday morning (below) re: various rate increases on the OMH side of the world.
1) Yesterday morning when we met with Emil Slane during our weekly Member Support and Public Policy call, we heard a lot of good news regarding rate changes to some OMH Programs and Services. I sent the email (below) to everyone before I spoke to him again, later in the day. I asked him to please review the info I sent everyone and he said I was correct on all points, however he mentioned that I had –undervalued- the temporary increase for Outpatient Clinics that I had put at 10% for 8 months (see highlighted sentences below). Today I learned that that temporary increase is more like 11.5% for the 8 month period. And finally, the actual 8 month period is January 1, 2022 – September 30, 2022. Again, providers will see rates decrease at the end of September to reflect the temporary period ending.
For those who are wondering how that particular bucket of funds came to be, the temporary 11.5% increase for 8 months is the result of the OMH Clinic having been approved to go from the (federal) ‘Clinic option’ to the (federal) ‘Rehab option’. Changing federal categories made the OMH Clinic eligible for eFMAP funds. The temporary increase reflects funds the state has applied to get from CMS in recognition of the Clinic having switched from Clinic to Rehab option during the enhanced FMAP period. 2) OMH intends to make both the COLA and the eFMAP increases available to hospital-based Article 28 Programs. I am uncertain whether OASAS is doing the same. I am waiting for a call back.
3) The COLA is a state budget outcome. The other 2 components (the 5% permanent and the 11.5% temporary) are pending SPA approval. I am told there is no cause for concern and that both are low risk, but they are still pending approval. I wanted to mention this since it was not mentioned on Thursday morning during our call.
———- Forwarded message ———
From: Lauri Cole <firstname.lastname@example.org>
Date: Thu, Apr 14, 2022 at 10:42 AM
Subject: Follow Up to NYS Council Thursday Meeting with Emil Slane, OMH CFO
Here is what we heard this morning:
1) The link below lists some of the many OMH rate changes due to eFMAP & OMH will be updating this info to include COLA @5.4% shortly. Will also be updating to reflect residential housing rate changes shortly.
OMH Outpatient Clinic rate changes
Outpatient Clinic Increases are composed of: 5.4% COLA increase (permanent – increases APG base rates) + 5% eFMAP increase (permanent, increases APG base rates) AND for 8 months, another 10% increase (temporary workforce increase that increases APG base rates).
So, it’s 10.67% (when compounded) that is permanent, PLUS another 10% for 8 months (retro to January 2022 and ending September 2022). NOTE: In September clinic rates will change (decrease) to reflect the end of 8 month temporary increase.
Funds NYS Council advocated to be returned to OASAS and OMH from MCOs failure to meet expenditure targets will be used to make the permanent 5% eFMAP increase (discussed above) that would otherwise have been temporary, permanent. FYI: Our efforts resulted in OMH getting back $74M state share that grosses to $148M; OASAS got back $37M state share that grosses to $74M = $222M total for MH and SUD systems of care.
Healthcare Workforce Bonuses (enacted as part of new state budget)
Up to $3,000/employee. See language re: eligible employees.
This is a multi-state agency initiative and so (internally) state leaders are meeting to iron out implementation across the healthcare landscape.
Can be distributed to staff over time – does not have to go out from your agency as lump sum payment to staff.
Eligible if earn less than $125k and meet other eligibility requirements in terms of vesting, job title.
eFMAP Rate Changes
Permanent rate changes include: PROS (10%) ACT (5%) and Community Residences (5%), effective 4/1/2022 – all have been approved by CMS and are retro to October 1, 2021.
Note: There are additional rate increases coming for OMH housing providers beyond this amount.
COLA (enacted as part of new state budget)
5.4% – mostly rate changes (CR’s not Medicaid funded but will get $65M.)
Health Home+ is eligible. DOH regulated HHCM not included. NYSSHP (overseen by OTDA) not included.
There is some deficit funding (state aid) in ACT but the 5% increase (mentioned above) is only on the Medicaid portion of the ACT rates.