HEADS UP: DOH Medicaid Update: 1.5% Across the Board (ATB) Medicaid Payment Reductions FOR SOME PROVIDERS
May 20, 2020
Per the enacted State Budget for SFY 2020-21, the state is moving forward with the across-the-board Medicaid cut of 1.5% for dates of service on or after April 2.
The attached update includes a chart outlining the services that this cut applies to and lists those that are exempt.
The information reflects that OPWDD Article 16, OMH Article 31 and OASAS Article 32 are exempt from the reduction.
1.5% Across the Board (ATB) Medicaid Payment Reductions Effective for dates of service on or after April 2, 2020 and each State Fiscal Year thereafter, all non-exempt Department of Health state funds Medicaid payments will be uniformly reduced by 1.5%. For services subject to the 1.5% reduction, all fee-for service payments will receive a decrease to Medicaid checks and/or Electronic Funds Transfers for dates of services on or after April 2, 2020. Conversely, managed care payments to health plans will be reduced through a 1.5% reduction to premium rates effective April 2, 2020. Remittances will reflect the prospective 1.5% reduction (appearing as an “FC2” recoupment) starting in cycle 2231, which has a check release date of 06/10/2020 (distressed providers will have a check release date of 05/27/2020). Retroactive adjustments to previously submitted claims with dates of service spanning April 2, 2020 through May 13, 2020 will be made at a future date. Please Click Here to read the full provider notice. |