August 29, 2022

Following is a note from our government relations consultant Marcy Savage at Reid, McNally and Savage.  It speaks to specific information that was part of the content in the slide deck that DoH sent out today via the MRT list serv regarding the HCW Bonus Program   We sent you that information today at 4:10 p.m.

As always, if you have questions or concerns, we are here to provide an assist.

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Hi Lauri,
NYSDOH recently published a slide deck from a taped Town Hall on NYS’ Healthcare Worker Bonus program. Making sure that you saw Slide 6 of the slide deck has updated employer eligibility criteria (also embedded below in red):
Slide 6: Correction Employer Eligibility Clarification 
• The statute provides two separate definitions for qualified employers, both of which are subject to the requirements of the Healthcare Workforce Bonus (HWB) program. 
• See SOS § 367-w(2)(b) and (c). 
• Under paragraph (2)(b), an employer is subject to the HWB program if they meet all of the four following criteria: 
1. They are a Medicaid enrolled provider 
2. They bill for Medicaid services (either through FFS, managed care, or a 1915(c) waiver) 
3. Employ at least one eligible employee 
4. A. Are included in the list of provider and facility types in the statute, OR
B. Subject to a certificate of need (CON) process, OR
C. The Employer serves at least 20% Medicaid enrollees 

Since “Article 31 and 32 providers” are an eligible provider type expressly listed in the statute (see statute language embedded below), this updated criteria should enable all 31/32 providers who are enrolled in Medicaid, bill for Medicaid services and have eligible employees, to participate even if they do not meet the 20% Medicaid threshold listed in 4 C above.

(b) “Employer” means a provider enrolled in the medical assistance ______________________________________________________________________
11 program under this title that employs at least one employee and that ________________________________________________________________________
12 bills for services under the state plan or a home and community based ________________________________________________________________________
13 services waiver authorized pursuant to subdivision (c) of section nine- ________________________________________________________________________
14 teen hundred fifteen of the federal social security act, or that has a ________________________________________________________________________
15 provider agreement to bill for services provided or arranged through a ________________________________________________________________________
16 managed care provider under section three hundred sixty-four-j of this ________________________________________________________________________
17 title or a managed long term care plan under section forty-four hundred ________________________________________________________________________
18 three-f of the public health law, to include: _____________________________________________
19 (i) providers and facilities licensed, certified or otherwise author- ______________________________________________________________________
20 ized under articles twenty-eight, thirty, thirty-six or forty of the ________________________________________________________________________
21 public health law, articles sixteen, thirty-one, thirty-two or thirty- ________________________________________________________________________
22 six of the mental hygiene law, article seven of this chapter, fiscal ________________________________________________________________________
23 intermediaries under section three hundred sixty-five-f of this title, ________________________________________________________________________
24 pharmacies registered under section six thousand eight hundred eight of ________________________________________________________________________
25 the education law, or school based health centers; __________________________________________________
26 (ii) programs that participate in the medical assistance program and ______________________________________________________________________
27 are funded by the office of mental health, the office of addiction ________________________________________________________________________
28 services and supports, or the office for people with developmental disa- ________________________________________________________________________
29 bilities; and _____________
30 (iii) other provider types determined by the commissioner and approved ______________________________________________________________________
31 by the director of the budget; ______________________________
32 (iv) provided, however, that unless the provider is subject to a ______________________________________________________________________
33 certificate of need process as a condition of state licensure or ________________________________________________________________________
34 approval, such provider shall not be an employer under this section ________________________________________________________________________
35 unless at least twenty percent of the provider’s patients or persons ________________________________________________________________________
36 served are eligible for services under this title and title XIX of the ________________________________________________________________________
37 federal social security act.

Also of note, the Department is not prescribing a specific methodology to determine the 20 percent Medicaid threshold criteria. The onus is on the employer to determine whether it is in compliance with this criteria as part of the employer attestation which is required as part of the HWB claim submission process.

For more information on this program please visit: https://www.health.ny.gov/health_care/medicaid/providers/hwb_program/

Please note the next taped Town Hall will be held September 2nd and the slides will be posted then as well.

For questions, providers are being asked to contact the Health Care Worker Bonus (HWB) Call Center at: (866) 682-0077 or email the HWB Mailbox: NYSWorkersBonus@health.ny.gov