December 16, 2020

We have a variety of news to share:

First, a NYS Council member agency graciously let us know that they recently received an award of additional funding (beyond the 2% of total gross revenues) from HRSA.  This is from the 3rd truancy of Provider Relief Funds (Round 3).  Our member agency received a letter from HRSA but the letter didn’t include the amount of the award and so they checked their bank accounts to learn how much had been awarded to them.  Note to self:  Be on the look out for these funds!

Next, on the matter of Fidelis and MVP being permitted to drop Walgreens and Duane Reade out of their in network pharmacies for MMC, MLTC, Essential Health Plan and CHP beneficiaries effective 1/1/2021, we have had numerous discussions with the Governor’s Office, and with the Director at the DoH Office of Health Insurance Programs (OHIP).  Today, OHIP reached out to schedule a follow-up discussion to the initial call we had with them last week.  They are calling it an “update”.  Hopefully this is good news but its’ still unclear.  Please continue to speak with the individuals you work with to ascertain if they need assistance in understanding the notice they (hopefully) received on this matter, and to ensure they take advantage of the 30 day refill they are apparently entitled to.  Know that we are working aggressively on behalf of these individuals to persuade the state to rescind the approvals granted to Fidelis and MVP, but the odds (and the calendar) are not in our favor.

Finally, attached, please find the following rule makings published today in the NY State Register for your review:

  • A Notice of Adoption issued by the Department of Corrections and Community Supervision related to Special Housing Units (SHU) updating rules to comply with new laws regarding special housing units, and solitary confinement use;
  • An Emergency Rule Making issued by the Department of Financial Services related to Minimum Standards for Form, Content, and Sale of Health Insurance, Including Standards of Full and Fair Disclosures.  In particular, this rule continues to waive the copays/coinsurance for essential workers receiving in-network outpatient mental health services through 1/26/21; and
  • A Notice of Adoption issued by NYSDOH related to Reducing Annual Tuberculosis Testing of Health Care Workers. The adopted rule applies to all hospitals, hospices, home care agencies (CHHAs, LHCSAs) and Assisted Living Residences and states that for all personnel prior to employment or affiliation, except for personnel with no clinical or patient contact responsibilities who are located in a building or site with no patient care services, an initial individual tuberculosis (TB) risk assessment, symptom evaluation, and TB test must be given (either tuberculin skin test or Food and Drug Administration (FDA) approved blood assay for the detection of latent tuberculosis infection), and annual assessments thereafter with testing based on symptoms suggestive of TB disease.  These changes conform to new CDC recommendations.

Finally, the Adopted rule we commented on earlier in the year relating to new expectations for health plans in terms of their  Parity Compliance Programs, is set to be (formally) implemented effective 12/29/20. 

Please let us know if you have any questions.