NY State Medicaid Payment Reductions

Effective April 2, 2020, and each State Fiscal Year thereafter, all non-exempt Department of Health state funds Medicaid payments will be reduced by 1.5%. All fee-for-service payments will receive a decrease to checks and EFTs for dates of services on or after April 2, 2020, including managed care payments under the same conditions. Remittances will indicate the prospective 1.5% reduction, starting with a check release date of 06/10/2020. Retroactive adjustments to previously sent claims with dates of service starting April 2, 2020, through May 13, 2020, will be performed at a future date.

However, some of the payments will not be affected by the reduction, such as:

1) Payments whereby Federal law precludes such reduction, including:

· Federally Qualified Health Center (FQHC) services and Residential Health Clinics;

· Supplemental Medical Insurance – Part A, Part B;

· Medicare Part D payments;

· Services provided to American citizen repatriates;

· Hospice Services

2) Payments funded exclusively with federal and/or local funds.

3) Other specific payments:

· Payments pursuant to Articles 32, 31 and 16 of the Mental Hygiene Law;

· Required payments related to the School Supportive Health Services Program and Preschool Supportive Health Services Program;

· Value Based Payment Quality Improvement Program;