14 Mar Budget Update: Senate Includes 8.5% COLA in One-House, NO Wage Enhancement

The New York State Senate has released their One-House Budget proposal. The Senate budget resolution in response to the 2023-2024 Executive Budget submission can be found here. Highlights are below.

We are currently reviewing and will be sending any items of interest directly to you. At this time, the Assembly has not released any budget documents; we will alert you once they do.

The Assembly and Senate are expected to adopt their respective One-House Budget proposals this week. The Conference Committee process will begin once both the Senate and Assembly pass their individual One-House Budget proposals.

SENATE ONE HOUSE 2023-2024 BUDGET HIGHLIGHTS

OPWDD

• Adds $290 million for an 8.5% COLA and indexing future cost-of-living adjustments to the consumer price index (Part of S.1291). (S.4007-B PART DD)
• Reduces the OPWDD managed long-term care statute to one (S.4007-B PART EE)
• Accepts the increased flexibility in delegating nursing tasks by allowing direct support staff in OPWDD community-based programs to perform certain tasks, if under the instruction of the service recipient or their representative and supervised by a registered professional nurse. (S.4007-B PART FF)
• NEW PART NN S.4007-B — to create an independent intellectual and developmental disability ombudsman program (S.3108).
• Adds $1 million to support Legislative Grants, including a $450,000 restoration to support prior year Legislative Grants.
• NO funding or mention of the $4,000 Direct Support Wage Enhancement

SED

• Amends $2.5 million special education tuition methodology study – remove the cost neutral language, to ensure the fiscal stability of these programs, and to provide predictable annual funding levels;
• Adds Reserves prior to reconciliation – Allow Special Act School Districts, 853 schools, and 4410 schools to retain the 11% cost of living increase before the reconciliation process occurs (S.9132 of 2022);
• Requires interim plus rates – requires the annual growth amount be included for such rates approved in the current school year and annually thereafter for Special Act School Districts, 853 schools, and 4410 schools (amended version of S.9134 of 2022);
• Requires Tuition Parity – requires rates for all Special Act School Districts, 853 schools, and 4410 schools commensurate with the state aid increases (amended version of S.6516-A of 2022)

DOH

• Adds an 11% Early Intervention Rate increase – $23 million to support an 11 percent Reimbursement Rate Increase for Early Intervention programs.
• Maintains Prescriber Prevails – PART D — intentionally omits the Executive proposal to allow the Department of Health to eliminate drugs from the Medicaid list of over-the-counter covered drugs and eliminate prescriber prevails from Medicaid.
• Accepts Medicaid Buy In Expansion – PART N — to expand the Medicaid Buy-In Program for working people with disabilities.
• Rejects Interstate Licensure Compact and Nurse Licensure Compact – PART W — intentionally omits the Executive proposal to expand the scope of practice for medical providers and the introduction of the Interstate Licensure Compact and Nurse Licensure Compact
• Modifies fifth round of grants for the Statewide Health Care Facility Transformation Program- PART P — The Senate modifies the Executive proposal to authorize a fifth round of grants for the Statewide Health Care Facility Transformation Program by providing $200 million in additional funding, creating a $200 million set-aside for community-based organizations, specifically identifying cybersecurity projects within the $500 million for technological and telehealth set-aside, adding language to allow this funding to support conversion of buildings and new construction in underserved communities, and setting aside $50 million for community-based organizations to engage in these activities.
• NEW PART TT — to conduct a study on the Medicaid durable medical equipment, prosthetics, orthotics, and supply program, focused on rate adequacy and patient access (S.3131).
• NEW PART VV — to repeal the 340B carve out, require managed care providers (MCPs) and pharmacy benefit managers (PBMs) to use the fee-for-service preferred drug list in developing their formulary, require MCPs and PBMs to reimburse retail pharmacies and 340B covered entity providers for each drug at the National Average Drug Acquisition Cost (NADAC) or the fee-for-service reimbursement rate plus a tiered volume-based dispensing fee, require a dispensing fee set by the Commissioner to be an amount of at least $10.18, prohibit MCPs from denying retail pharmacies the opportunity to participate in their network, reimburse contract pharmacies under the 340B program under a fee schedule based on fair market principles and not on a percentage of a claim’s total reimbursement or net margin, and prohibit PBMs from limiting an individual’s choice to receive their medication from their local, non-mail order pharmacy of choice (S.5136). * NEW PART WW — The Senate advances language to expand the number of facilities in the young adults with medical fragility demonstration program
• NEW PART CCC – for DOH to establish rates of reimbursement for pediatric diagnostic and treatment centers for services provided on or after April 1, 2023, to children with medical fragility.
• NEW PART RR — increase the minimum wage for home care workers by an additional two dollars over two years subject to federal participation, require the Department of Health (DOH) to make state-directed payments to providers for the purposes of supporting wage increases, and allow the Comptroller to review contracts between managed care organizations and licensed home care services agencies, fiscal intermediaries, or any agencies subject to the home care minimum wage increase, to ensure that rates being offered are adequate and meet the Department’s actuarial standards. Should the Comptroller find evidence of inadequate rates, it will refer such instances to DOH and the Medicaid Fraud Control Unit (OMIG) for enforcement. DOH and OMIG will have the ability to not act on the referral. The reports and responses will be public information and made available in the Comptroller’s website (Part of S.3189)
• NEW PART FFF — funding for certified home health agencies and hospice programs to increase their services in underserved or hard to serve areas of the state.
• $1 billion in State funding for Financially Distressed and Safety-Net Hospitals.
• $624 million for State-share Medicaid local takeover growth.
• $412.5 million to support ten percent Reimbursement Rate Increase related to the modifications HMH Part E.
• $187 million to support safe staffing for Nursing Home.
• $157.5 million to support a ten percent Reimbursement Rate Increase related to the modification of HMH Part I.

OMH

• Adds $130 million to support an 8.5%
• Accepts the proposal to allow the Office of Mental Health and the Office of Addiction Services and Supports to jointly license certified community behavioral health clinics and create an Indigent Care Pool to compensate providers who suffer losses due to uncompensated care. (PART HH)
• Accepts the Executive proposal to require commercial insurance coverage of certain behavioral health services, exempt certain behavioral health services and substance use disorder drugs from preauthorization or utilization review, require payment parity for telehealth mental health services, create penalties for payment parity violations, and require DFS to promulgate regulations related to behavioral health and substance use disorder network adequacy.
• Modifies the Executive proposal to enhance the authority of the Commissioner to impose penalties on providers for failing to comply with operating certificates or the Mental Hygiene Law by including protections for attempts made in good faith to comply with applicable operating certificates and the law. (PART JJ)