On November 8, 2019, the New York State Legislature passed an amendment positively impacting the reimbursement made by Medicaid managed care plans and managed long-term care plans to behavioral health providers.
If you are a behavioral health provider and receive reimbursements from a Medicaid managed care plan or a managed long-term care plan at your Medicaid rate or a percentage thereof, effective November 8, 2019, the Medicaid managed care plan or a managed long-term care plan must adjust the reimbursement paid to you so that it reflects any adjustment the Department of Health (“DOH”) makes to your Medicaid rate as of the effective date of DOH’s adjustment.
In addition, Medicaid managed care plans and managed long-term care plans must make retroactive payments to behavioral health providers to account for changes in rates from the date DOH changes the Medicaid rate to the date the payment is paid to you.
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Should you have any questions regarding the above, please contact the Garfunkel Wild attorney with whom you regularly work.