PCMH Increase Update: SCN Attestation Requirements

The PCMH incentive increase included in the 2024-2025 state budget has been approved by CMS, and the state is working to distribute payments soon. These payments will be retroactive to April 1, 2024. The incentive payments are $2 per member per month (PMPM) for adults and $4 PMPM for children under 21. For more information, see the Medicaid Update here. 

Starting April 1, 2025, this increase will be contingent on health centers attesting that they have a workflow to refer patients to Social Care Networks (SCNs), which provide enhanced Health-Related Social Needs (HRSN) services to Medicaid patients. These services include housing supports, nutritional supports, care coordination, and transportation.

To continue receiving the incentive, health centers need to complete an attestation by March 31, 2025, confirming that the practice has established at least one of the following workflows:

• Connecting patients to the regional SCN(s) via referral provided to the patient,
• Connection directly with the SCN platform or through a regional Qualified Entity to submit Accountable Health Communities Health Related Social Needs screenings and referrals for Medicaid members, or
• Connection with SCNs in another agreed-upon way.

The attestation must be completed for each physical site, but you can submit for multiple sites at the same time. If submitted after March 31, payments will begin the following month (e.g., submitting on April 15 means increased payments restart in May 2025).

To access the attestation, please go to: https://smartforms.health.ny.gov/public?formId=675a009d3aad5089bec295b0. The password is NYSPCMH25.

For more information, please refer to the official communication from the state: DOH Email NYS PCMH Medicaid and CHPlus Incentive Enhancement*.

*Previous communications from DOH indicated that the attestation could be accessed through the Health Commerce System (HCS) portal; however, this is no longer accurate. Please use the link and password provided above instead.

More information can be found on the SCN Health Care Provider page: Information for Health Care Providers.

Frequently Asked Questions

1. What type of agreement is required with the SCN?
   Providers should contact the SCN to discuss their patient workflow for Medicaid members and determine with the SCN the best way to refer Medicaid members to the SCN. The agreement with the SCN can be formal or informal.
2. Can I connect a patient to an SCN by giving the members marketing materials from the SCN?
   Yes, this is acceptable under option 1.
3. Can I have the member complete a self-screening on the SCN website using a tablet in the office?
   Yes, this is acceptable under option 3.
4. Can a provider office screen a member with the AHC tool, send the screening from their EHR to the Regional Qualified Entity/ SHIN-NY data lake? If yes, is the screening eligible for payment from the SCN?
   Yes, this is acceptable under option 2 and would be eligible for payment through the SCN.
5. What are the screening questions that need to be asked if a provider's office is doing the screening?
   Please see the screening and data elements on the DOH SCN Provider website: Information for Health Care Providers.
6. Can I refer a patient that is not enrolled in Medicaid to the SCN?
   No. At this time, only Medicaid members can be referred to the SCN. Please use other resources, such as 211/311, NY Connects, a list of community organizations, etc., to help refer non-Medicaid insurance types to resources.
7. Can I just refer all patients, including those enrolled in Medicaid, to 211 instead of the SCN?
   No, this would not be an acceptable arrangement. The SCN is separate from 211, and Medicaid members will need to be referred to the SCN.