Public Notices: State Seeks to Amend Title XIX for Medicaid Redesign

April 1, 2020

Today in the State Register, there are two Public Notices by NYSDOH.

“The [DOH] proposes to amend the Title XIX (Medicaid) State Plan for inpatient,

long term care, and non-institutional services to comply with recently

proposed statutory provisions.”

https://www.dos.ny.gov/info/register/2020/040120.pdf

(page 87 within the document)

The Notices state that NYSDOH proposes to amend the Title XIX (Medicaid) State Plan to pursue significant changes to inpatient, long term care, and non-institutional services.  This means that they are seeking federal approval to make such changes.  While we await the release of the final state budget bills related to HMH/Medicaid, it may be that these are the MRT 2 items that they reached a three-way agreement to move forward this year so they are filing notice (with the federal government and the public) of SPA amendment today.

The first public notice states that NYSDOH plans to uniformly reduce all non-exempt Medicaid payments uniformly by $2.5 billion, only to the extent that alternative methods that achieve Medicaid state savings are not achieved (see below).  Note, exempt from reductions are payments pursuant to  Article 32, 31 and Article 16 of mental hygiene law and payments provided by other state agencies including OCFS, SED and DOCCS, among others.

The second public notice lays out the specific Medicaid reforms NYSDOH is seeking approval to move forward with to achieve these savings, as recommended by MRT 2.  Again, these proposals apply to inpatient, long term care, and non-institutional services.  We have outlined the items of particular interest to CCBH below:

1.875% across the board Medicaid cut

Again on the list of what is exempt from such reductions are payments pursuant to Article 32, 31 and Article 16 of mental hygiene law and payments provided by other state agencies including OCFS, SED and DOCCS.

MRT 2.0 Proposals 

In terms of the second public notice the following MRT 2.0 proposals (sent by MRT 2.0 group to the Governor for further action) appear to be those the state is seeking approval to move forward.  They include:

  • Implement Health Home Improvements
  • Comprehensive Prevention and Management of Chronic Disease.
  • Children’s Preventative Care and Care Transitions promoting behavioral health integration in pediatrics.
  • Children and Family Treatment and Support Services (CFTSS) to restore specialized transition rates for CTFSS.
  • Invest in Medically Fragile Children.
  • Emergency Room Avoidance and Cost Reductions.
  • Addressing Barriers to Opioid Care by implementing a series of interventions including better bundled payments through APG adjustments,
  •  Reducing Medicaid Coverage limits for Rehab Services and increased utilization of Opioid Medical Maintenance.
  • Reducing certain OTC coverage and increase copays.
  • Eliminating prescriber prevails under FFS.
  • Expand use of telehealth specifically to address behavioral health and certain other population needs.

MANY thanks to Marcy Savage at Reid, McNally and Savage for quickly analyzing and sharing with us the information above!

Please let us know if you have any questions.