OMH-32-08-00001-P Medical Assistance Payment for Outpatient Programs

8/6/08 N.Y. St. Reg. OMH-32-08-00001-P

NEW YORK STATE REGISTER

VOLUME XXX, ISSUE 32

August 06, 2008

RULE MAKING ACTIVITIES

OFFICE OF MENTAL HEALTH

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. OMH-32-08-00001-P

Medical Assistance Payment for Outpatient Programs

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:

Action taken:

This is a consensus rule making to amend Part 588 of Title 14 NYCRR.

Statutory authority:

Mental Hygiene Law, sections 7.09 and 43.01

Subject:

Medical assistance payment for outpatient programs.

Purpose:

To provide increased reimbursement rates & COLAS for certain mental health treatment programs as per the 08–09 State budget.

Text of proposed rule:

1. Paragraph (4) of subdivision (a) of section 588.13 of Title 14 NYCRR is amended to read as follows:

(4) Reimbursement under the medical assistance program for day treatment programs serving children shall be in accordance with the following fee schedule.

(i) For programs operated in Bronx, Kings, New York, Queens and Richmond counties:

Full day	at least 5 hours	$[76.25] 79.48
Half day	at least 3 hours	[38.13] 39.75
Brief day	at least 1 hour	[25.42] 26.50
Collateral	at least 30 minutes	[25.42] 26.50
Home	at least 30 minutes	[76.25] 79.48
Crisis	at least 30 minutes	[76.25] 79.48
Preadmission- full day	at least 5 hours	[76.25] 79.48
Preadmission- half day	at least 3 hours	[38.13] 39.75

(ii) For programs operated in other than Bronx, Kings, New York, Queens and Richmond counties:

Full day	at least 5 hours	$[73.71] 76.84
Half day	at least 3 hours	[36.85] 38.41
Brief day	at least 1 hour	[24.53] 25.57
Collateral	at least 30 minutes	[24.53] 25.57
Home	at least 30 minutes	[73.71] 76.84
Crisis	at least 30 minutes	[73.71] 76.84
Preadmission- full day	at least 5 hours	[73.71] 76.84
Preadmission- half day	at least 3 hours	[36.85] 38.41

2. Subdivision (b) of section 588.13 of Title 14 NYCRR is amended to read as follows:

(b) Reimbursement under the medical assistance program for regular, collateral, and crisis visits to all non-State operated partial hospitalization programs licensed pursuant to Article 31 of the Mental Hygiene Law and Part 587 of this Title shall be in accordance with the following fee schedule.

(1) For programs located in Nassau and Suffolk counties, the fee shall be $[22.66] 23.39 for each service hour.

(2) For programs located in New York City, the fee shall be $[29.76] 30.71 for each service hour.

(3) For programs located in the counties included in the region of New York State designated by the Office of Mental Health as the Hudson River Region, the fee shall be $[25.01] 25.81 for each service hour.

(4) For programs located in the counties in the region of New York State designated by the Office of Mental Health as the Central Region, the fee shall be $[17.15] 17.70 for each service hour.

(5) For programs located in the counties included in the region of New York State designated by the Office of Mental Health as the Western Region, the fee shall be $[21.26] 21.94 for each service hour.

3. Subdivision (c) of section 588.13 of Title 14 NYCRR is amended to read as follows: (c) Reimbursement under the medical assistance program for on-site and off-site visits for all non-state operated intensive psychiatric rehabilitation treatment programs, licensed pursuant to Article 31 of the Mental Hygiene Law and Part 587 of this Title shall be at $[24.42] 25.20 for each service hour.

Text of proposed rule and any required statements and analyses may be obtained from:

Joyce Donohue, Office of Mental Health, 44 Holland Ave., 8th Fl., Albany, NY 12229, [phone], e-mail: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

Consensus Rule Making Determination

This rulemaking is filed as a Consensus rule on the grounds that its purpose is to implement or conform to non-discretionary statutory provisions. No person is likely to object to this rulemaking since it conforms to Chapter 54 of the Laws of 2008, the enacted State Budget for 2008–09, by providing increased medical assistance reimbursement rates for free-standing Children's Day Treatment Programs and cost of living adjustments (COLA) for the Office of Mental Health's Partial Hospitalization Programs and Intensive Psychiatric Rehabilitation Treatment Programs (IPRT). There are no costs to providers or local governments associated with these amendments. Pursuant to Mental Hygiene Law, these rate increases have been approved by the Director of the Division of the Budget.

The language authorizing the increase to medical assistance payments for free-standing children's day treatment programs appears on page 404 of Chapter 54 of the Laws of 2008. Implementation of the increased medical assistance payments for free-standing children's day treatment programs was budgeted to cost New York State $300,000 annually, and appropriations for the state share of Medicaid were included on page 404, line 12, of Chapter 54 of the Laws of 2008.

The language authorizing the 2008–09 COLA for Partial Hospitalization and certain other programs appears on pages 391–392 and 402 of Chapter 54 of the Laws of 2008. Implementation of the 2008–09 COLA was budgeted to cost New York State $102,720 annually, and appropriations for the state share of Medicaid were included on page 393, line 12, of Chapter 54 of the Laws of 2008 and page 403, line 43, of Chapter 54 of the Laws of 2008.

The language authorizing the 2008–09 COLA for IPRT and certain other programs appears on pages 391–392 and 402 of Chapter 54 of the Laws of 2008. Implementation of the 2008–09 COLA was budgeted to cost New York State $197,046 annually, and appropriations for the state share of Medicaid were included on page 393, line 12, of Chapter 54 of the Laws of 2008 and page 403, line 43, of Chapter 54 of the Laws of 2008.

As the requirements identified above conform to non-discretionary statutory provisions, this rulemaking is non-controversial and is appropriately filed as a Consensus rule. These regulatory amendments will be effective upon their adoption, and the rate increases and COLAs associated with the 2008–09 enacted budget shall be deemed to have been effective on April 1, 2008.

Statutory Authority: Section 7.09 of the Mental Hygiene Law grants the Commissioner of the Office of Mental Health the authority and responsibility to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction.

Section 43.01 of the Mental Hygiene Law gives the Commissioner the authority to set rates for outpatient services at facilities operated by the Office of Mental Health. Section 43.02 of the Mental Hygiene Law provides that payments under the medical assistance program for outpatient services at facilities licensed by the Office of Mental Health shall be at rates certified by the Commissioner of Mental Health and approved by the Director of the Division of Budget.

Job Impact Statement

A Job Impact Statement is not submitted with this notice because it merely provides for increased medical assistance reimbursement rates for free-standing Children's Day Treatment Programs and cost of living adjustments (COLA) for the Office of Mental Health's Partial Hospitalization Programs and Intensive Psychiatric Rehabilitation Treatment Programs (IPRT), consistent with the enacted budget for State Fiscal Year 2008–09. It is evident that there will be no adverse impact on jobs and employment opportunities.