Tuesday, Governor Hochul released her proposed FY23 Executive Budget. The Governor has committed to expansive investments in the health care and social services sectors. Please note that both the State Assembly and Senate will also release their own versions of the budget bills, and nothing is guaranteed until the final budget is passed on or around March 31. We will continue to keep you updated of new developments as they arise. Below are highlights of the budget of interest to health centers.
- Administrative action to disregard 2020 MCVR rate year: The Department of Health will not adjust supplemental wraparound rates based on the 2020 MCVR. FQHCs will continue to receive the 2019 wrap rates for the 2020 rate year.
- Telehealth Payment Parity: Medicaid and Commercial reimbursement parity for telehealth including, audio-only, when the health center serves as either the originating or distant site (i.e. health centers will receive their threshold rate). Audio-only visits where both provider and patient are offsite (i.e., in their respective homes) will continue to be reimbursed at the offsite rate.
- $10 billion multi-year health care investment including:
- $2 billion to support healthcare worker wages;
- $1.2 billion to support healthcare and mental hygiene worker retention bonuses, with up to $3,000 bonuses going to workers earning less than $100,000, who remain in their positions for one year for providers who serve at least a 20 percent Medicaid population, and pro-rated bonuses for those working fewer hours – CHCANYS has confirmed that health center staff are eligible for these bonuses;
- $2.4 billion for healthcare capital infrastructure and improved lab capacity; and
- Other investments in workforce and healthcare access and delivery.
- Level Funding for CHC Supported Programs:
- Patient Centered Medical Homes $220M
- Health Homes $524M
- Uncompensated Care Safety Net Pool $54.4M
- Doctors Across New York (DANY) $9M
- School Based Health Centers $8.32M
- Rural Health Access Networks $9.4M
- Migrant and Seasonal Farm Worker $406K
- Statewide IV: $1.6 billion Statewide Health Care Facility Transformation Program IV including:
- $25 million capital investment for community-based health care providers.
- $150 million investment for telehealth infrastructure.
- “Nurses Across New York (NANY)” nurse loan repayment program:
- Establishes a nurse loan repayment program for individuals who complete three years of service in an underserved area.
- $2.5 million in FY 2023: 1/3 to be allocated to NYC, 2/3 to be allocated to rest of state.
- Directs the Department of Health to establish a workgroup of associations representing health care facilities to issue recommendations on a streamlined application process by 2022.
- Interstate Medical Licensure Compact: Enables New York to join the interstate medical licensure compact and Nurse Licensure Compact, allowing health care professionals with out of state licenses to practice in New York.
- Scope of Practice Reforms:
- Makes the Nurse Practitioner Modernization Act permanent and removes the requirement for NPs with over 3,600 practice hours to have a collaborative agreement with a physician.
- Allows pharmacists to order and administer certain diagnostic tests (e.g., COVID-19 tests).
- Allows physicians and Nurse Practitioners to issue standing orders for COVID-19, flu, and other respiratory illness tests and allows individuals to collect specimens for testing under the supervision of a physician, NP, or RN.
- Global Cap: Changes the Medicaid Global Cap indexed growth metric to the five-year rolling average of CMS Medicaid spending projections to more accurately reflect growth in spending, enrollment, and utilization factors including pandemic impacts. The total Global Cap spending growth in FY 2023 is estimated at $966 million using the new metric ($366 million above the existing cap).
- Managed Care Reforms:
- Directs the Department of Health to competitively procure for Medicaid Managed Care Organizations (MCOs)and to award 2-5 MCOs per geographic region.
- Instructs the Department of Health in its selection of awardees to consider criteria such as accessibility, geographic distribution, network sufficiency, cultural and language competencies, participation in value based payment arrangements, and quality improvement.
- Establishes a moratorium on new MCO approvals until the RFP is issued.
- Essential Plan Reforms:
- Expands eligibility up to 250% of FPL for legally permanent residents.
- Extends coverage to pregnant individuals for one year postpartum.
- Children born to an individual covered by EP will be eligible for MA.
- Note: does not include coverage expansion for undocumented immigrants.
- Maternal Health Reforms:
- Expands prenatal and postpartum care as standard Medicaid coverage.
- Extends Medicaid coverage to pregnant individuals for one year postpartum.
- Requires third trimester syphilis screenings.
- Requires commercial insurers to cover abortion services without cost-sharing.
- Child Health Plus Reforms:
- Aligns CHP benefits with the Medicaid program.
- Eliminates premium contributions for households up to 223% FPL.
- Moves rate-setting authority from DFS to DOH.
- Medicaid Eligibility: Expands Medicaid eligibility by eliminating the resource test and increasing income limits for older adults and disabled individuals.
- Reinvestment of Behavioral Health Savings: Requires the reinvestment of savings from the Behavioral Health transition from Fee-for-Service to Managed Care to be reinvested in Behavioral Health services.
- Access to Naloxone and Buprenorphine: Requires pharmacies to maintain a stock of both opioid antagonist medication (Naloxone) and opioid antagonist medication (Buprenorphine).
- Conforms State law with the Federal No Surprises Act
- Certificate of Need: Clarifies criteria for the Certificate of Need process.
- Discontinues the Prescriber Prevails provision: Eliminates the ability for prescribers’ determination to stand when the justification for medication use is not clinically supported, except in nine special drug classes within Managed Care.
- Likely to be brought back by the Legislature.
- Extends APG Methodology through 2027