2019 State Agency News

2019 State Agency News


December 20 – New Guidance on MH and SUD insurance coverage
The link below is to newly issued guidance about insurance coverage for SUD and MH.  https://www.dfs.ny.gov/reports_and_publications/press_releases/pr1912201

There are links at the bottom of the document to regulatory guidance on the new laws and, importantly, guidance affirming that NYS insurers are required to pay for CRPA peer support services.

December 17 – Criminal Background Check Reminders
Evidence of Rehabilitation and Good Conduct –this documentation is often necessary for the CBC Unit to complete their reviews and issue a determination.  We urge you to encourage your prospective hires, interns, contractors, volunteers to send in evidence of rehabilitation and good conduct at the time of fingerprinting (don’t wait for my office to send a letter).  It can be sent to cbc@oasas.ny.gov before, same day, or immediately after the person is fingerprinted.  This avoids delays.

Examples of evidence of rehabilitation and good conduct include: personal statement explaining their circumstances, a statement of responsibility, treatment information (if applicable), resume, letter from probation/parole (if applicable), or any other information he/she would like us to consider.

Employment statuses – update the applicant’s employment status in the system within 14 days of making a hiring decision.  We need this information.

Authorized Persons – take a look at your agency’s designation authorized persons.  If changes need to be made, email the CBC Unit at cbc@oasas.ny.gov.

November 6 – October Medicaid Update
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the October 2019 Medicaid Update. Please find the full current issue as a PDF (Portable Document Format) file available to be downloaded at: https://www.health.ny.gov/health_care/medicaid/program/update/2019/oct19_mu.pdf.

November 4 – LOCADTR Training
OASAS and the Center on Addiction are pleased to provide a new “training in a box” on the use of LOCADTR.   The training in a box concept came from in-person meetings held with providers and managed care plans last year.  We heard that flexible training that can be used by a specific staff member with supporting resources that can be used by a supervisor within a clinical meeting or staff training would help support ongoing learning within the work environment.  This training is the first of several planned over the next few years.   Please encourage staff to take this training and encourage clinical supervisors to utilize the training in supervision and clinical supervision.    Please follow the link to the training below.  We have included information on sign on to the learning management system with a link to simple directions below.   We encourage you to promote these trainings with staff to reinforce the accurate use of the LOCADTR.  This should reduce retrospective reviews and subsequent denials.

Please send feedback on this module to: CASAinfo@centeronaddiction.org

The LOCADTR TiB can be accessed here: https://learning.drugfree.org/course/view.php?id=9

This is the link to the youtube video for creating an account on the site: https://www.youtube.com/watch?v=YmUf1Zl1lCs.

Please send questions on access to the training to CASAinfo@centeronaddiction.org.

Feel free to send feedback about this training to:   PICM@oasas.ny.gov

October 24 – Claims Denials for Health Home Services by MCOs
DOH has issued a guidance document which contains important supplemental information regarding inappropriate claims denials for Health Home services by MCOs.  This document can be found at the link below.

September 8 – August Medicaid Update
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the August 2019 Medicaid Update

August 2 – July Medicaid Update
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the July 2019 Medicaid Update.

July 9 – OASAS: Peer Advocate Service Rate Enhancement Guidance
On March 25, 2019 The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 16-0004 which allows for a 50% rate enhancement for Part 822 Outpatient Program Peer Advocate Services.  Pending the NYS Department of Budget approval, the new enhanced rate will be available on September 1, 2019.

All Part 822 Outpatient Providers have been assigned a specific rate code for the enhanced Peer Advocate reimbursement rate.  Providers must utilize this rate code to receive the 50% enhancement.  Providers will receive a letter from the New York State Department of Health informing them that this new rate code has been loaded to their Medicaid profile.

The Peer Advocate Service Rate Enhancement Guidance along with the recently updated OASAS APG Clinical and Medicaid Billing Manual provide further information on this enhancement.

June 28 – OASAS: Updated APG Clinical and Medicaid Billing Guidance
The June 2019 APG Clinical and Medicaid Billing Guidance provides new clinical and billing information for OASAS Certified Outpatient Programs.  New information includes Problem Gambling reimbursement, Peer Advocate Service rate enhancement(s), along with clinical guidance for Intensive Outpatient Service (IOS), Group and Family Counseling Services.

June 25 – Allowable Licensed Practitioners of the Healing Arts (LPHA) for Children’s HCBS and CFTSS
The memo, Allowable Licensed Practitioners of the Healing Arts (LPHA) for Children’s HCBS and CFTSS and LBHPs for Children’s Other Licensed Practitioner services provides a detailed grid of allowable LPHAs and LBHPs for specific services to assist providers and Health Home Care Managers to ensure the correct practitioner is involved with the service to provide the necessary required documentation for that service.

June 12 – State Releases Guidance on Student Interns
The State has released guidance intended to clarify the role of Student Interns and those with a limited permit within the practice of the new State Plan Services of Children and Family Treatment and Support Services (CFTSS) and Waiver Services of Home and Community Based Services (HCBS).

June 11 – OASAS Releases 822 Q&A Document
Because of the number of inquiries related to the newly-promulgated 822 regulations, attached is a Q & A document we have developed answering those questions.   Please address any further inquiries to: legal@oasas.ny.gov.

June 5 – May Medicaid Update
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the May 2019 Medicaid Update.

May 17 – DOH Launches Electronic Visit Verification (EVV) Website
The New York State Department of Health has launched a webpage dedicated to sharing information on New York State’s implementation of an Electronic Visit Verification (EVV) system, as required by federal law under the 21st Century Cures Act.* This webpage includes program information, stakeholder information, frequently asked questions, and a calendar with important public engagement events specific to the implementation of EVV, and can be found at: https://www.health.ny.gov/health_care/medicaid/redesign/evv/index.htm.

Regional Listening Sessions have been scheduled for the coming months to provide Medicaid beneficiaries and family caregivers, home care agencies, home care workers, advocates, health plans, State agencies, and other interested parties an opportunity to have input in New York’s EVV design and implementation. To attend a session in your area, please register here.

The Department will be emailing an EVV Readiness Survey to providers delivering Personal Care Services (PCS) and Home Health Care Services (HHCS), and to Medicaid plans with providers who are delivering PCS and HHCS. This survey will help inform the planning process. To view a copy of the survey, please visit: http://www.health.ny.gov/health_care/medicaid/redesign/evv/2019_readiness_survey.htm.

If you are interested in receiving updates related to EVV, please sign up for the EVV ListServ. Please make sure to include the following in your email request: SUBSCRIBE EVV-L YourFirstName YourLastName

May 16 – Children’s HCBS updates and Guidance
The State has posted additional guidance on HCBS Provider Training Requirements ,  on HCBS Service Plan under the 1915c Children’s Waiver, and a HCBS Quick Reference Guide is a list of helpful documents and direct links to access documents and is not inclusive of all the details a provider will need to become familiar with providing HCBS to children.  If you have any questions regarding the additional guidance please contact us at BH.Transition@health.ny.gov

May 14 – April Medicaid Update
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the April 2019 Medicaid Update.

May 3 – OMH Specialty Designated Clinic services for children with SED carving into Medicaid Managed Care on July 1, 2019
As part of the NYS Medicaid Children’s System Transformation, OMH specialty designated clinic services for MMC enrolled children who have met criteria for a serious emotional disturbance (SED) will be carved into the Medicaid Managed Care Plan (MMCP) benefit package. This also includes children who have federal Social Security Insurance disability status or have been determined Social Security Insurance-Related by New York State (SSI children).

Currently, OMH specialty designated clinics are exempt from billing Medicaid managed care and bill Medicaid Fee-For-Service for children who meet criteria for SED who are enrolled in Medicaid Managed Care. Beginning July 1, 2019, OMH SED clinic providers will bill Medicaid Managed Care for these services for children enrolled in a MMCP using the same APG rate codes and procedure codes used for non-SED children. These procedures are defined in the New York State Health and Recovery Plan (HARP) / Mainstream Behavioral Health Billing and Coding Manual[1].

OMH wants to ensure providers are prepared to bill Medicaid Managed Care for this population beginning on 7/1/19 and will be providing additional guidance, training, and technical assistance on billing components and procedures leading up to this implementation. Please follow the Managed Care Technical Assistance Center[2] and the Children’s System Transition listserv[3] for announcements.

April 18 – HARP members transition from LDSS/HRA to on-line Medicaid enrollment
DOH released a FACT sheet that provides a quick guide to assisting Medicaid members who are being transitioned from the LDSS/HRA systems to the on-line Medicaid enrollment system, NY State of Health.  HARP members may need assistance in navigating this transition.

April 17 – ADHD Condition for Health Home Eligibility
Recently guidance was issued surrounding changes to the Health Home Chronic Condition for Eligibility.   Special notes include:

  • ADHD can be one of two chronic conditions
  • ADHD can be utilized as the primary condition for SED, if the functional limitations and the determination of SED has been made by a licensed mental health professional.
  • ADHD no longer required that past services within the last three years is needed

Changes to Health Home Serving Children (HHSC) Standards: Specific to SED as a single qualifying condition online here.

Eligibility Requirements: Identifying Potential Members for Health Home Services with list of Chronic Conditions online here.

April 3 – Criminal History Record Check Extension
The enacted State Budget extends the deadline by which temporary and prospective employees must receive a Criminal History Record Check clearance in order to provide direct care without being under direct supervision by three months to July 1, 2019. Upon signing, the law will be deemed effective April 1, 2019. While the bill awaits signature, the New York State Department of Health is suspending enforcement of the current April 1, 2019 deadline.

Specifically, this applies to those employees providing:

  • Health Home Care Management to enrollees less than 21 years of age;
  • Health Home Care Management to enrollees with a developmental disability as defined under section 1.03 (22) of the Mental Hygiene Law; and
  • Home and Community Based Services to those less than 21 years of age under the 1915c Children’s Waiver Amendment.

March 13 – Background Checks FAQ
The DOH has issued a Background Check FAQ as follow up to the CHRC Onboarding and Submission Process.

February 20 – Medicaid Update – Special Edition Telehealth
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of a Special Edition Medicaid Update focusing on Telehealth.

February 15 – OASAS developed a Person-Centered Care Guidance Document with the input of providers who advise on several OASAS committees and we vetted and revised the document based on feedback from provider forums over held in the fall of 2018.  We are pleased with the feedback that we have received and happy to release this document.  Providers have also requested support and training to operationalize the principles of person centered care.  OASAS is releasing training from the Center on Addictions, sponsored by the Managed Care Technical Assistance Center that can be found here.

Throughout the year, OASAS will work with providers, provider associations, the Center and others to continue to develop training opportunities.   Please send any questions to the PICM Mailbox at PICM@OASAS.ny.gov

February 1 – The DOH has released the February 2019 issue of the Children’s Medicaid Health and Behavioral Health System Transformation Update.

January 31 – The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the January 2019 Medicaid Update.

January 28 – OMH Guidance on OMH Licensed Clinic and Other Licensed Practitioner Services
OMH has issued guidance regarding the provision of Children and Family Treatment and Support Services (CFTSS), particularly Other Licensed Practitioner (OLP), for children who are receiving treatment services from an OMH licensed clinic.

The document is intended to provide guidance on when it may be appropriate to receive OLP and clinic services concurrently, and how the other rehabilitative services, Community Psychiatric Supports and Treatment (CPST) and Psychosocial Rehabilitation (PSR), may also help to support children while in clinic treatment.

If you have any questions regarding this guidance, feel free to contact OMH at DCFS@omh.ny.gov.

January 28 – CFTSS: Access/Referral Information
he state has provided links to the CFTSS brochure that can be printed/accessed by any referral access point. Also the link to the Home page for Children’s BH page is included.

The Home Page includes the following tabs:

  • Home
  • Children’s Medicaid System Transformation-Webinars/Trainings/Timelines
  • Children and Family Treatment and Support Services
  • 1915© Children’s Waiver and 1115 waiver
  • Provider Designation
  • Managed care organization (MCO) Qualification Process
  • Billing Guidance
  • Information for Consumers/Medicaid Recipients
  • Children’s Medicaid Redesign Team (MRT)
  • Voluntary Foster Care Agency Transition
  • Children’s Health Homes
  • Links/Learn More

The list of Providers Designated is also available.

January 14 – New Justice Center Guidance Available on the Web
After feedback from providers and the workforce, the Justice Center has modified the written guidance for mandated reporting requirements concerning vehicle and traffic incidents.  Examples of incidents occurring in vehicles are provided and an explanation of why the incident is or is not reportable to the Justice Center is included.  Please let your communities know about this new resource on the Justice Center website. The link to the document is https://www.justicecenter.ny.gov/sites/default/files/documents/Reporting%20Requirements%20for%20Custodians_Final.2019.pdf

January 10 – Updated Children and Family Treatment and Support Services (CFTSS) Manual
New York State (NYS) last issued the CFTSS Manual on June 20, 2018. At that time, we requested stakeholder feedback on the newly added “Standards of Care” in the appendix of the document. After receiving comments, we have integrated the edits to the manual and are reissuing an update version.   The updated version can be accessed at the following link: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/updated_spa_manual.pdf

January 7 – Guidance on Background Checks Requirements for current 1915c transitioning Home and Community Based Service (HCBS) providers that serve enrollees under age 21 is available hereRequirements need to be in place by April 1, 2019. Please reach out to HHSC@health.ny.gov with any questions you may have.