BUDGET PASSED BY LEGISLATURE CONTAINS SEVERAL MEANINGFUL NEW INITIATIVES
This past weekend, the New York State Legislature and Governor Hochul completed enactment of a $220 Billion State Budget for Fiscal Year 2022-23. Of importance to physicians, it includes:
- Telehealth Payment Parity. A law strongly advocated for by MSSNY (together with several specialty societies) requiring health insurers to pay equal for telehealth services that they would pay for comparable in-person services. The law will have to be extended in 2 years.
- Increasing Physician Loan Repayment. A 75% increase in funding (to nearly $16 million) for the Doctors Across New York student loan repayment program, where physicians can receive up to $120,000 in student loan relief for providing care (for at least 3 years) in an underserved area.
- Medicaid Payment Increases. A restoration of the 2020 1.5% cut to Medicaid payments and a further across the Board 1% payment increase. Moreover, effective April 1, E&M and Medicine codes in Medicaid fee for service are being increased to 70% of Medicare (currently at only 45% or 58% of Medicare).
- Med Mal Excess Restored. A straight one-year extension of the Excess Medical Malpractice Insurance program. MSSNY worked with specialty societies to fight back against an Executive Budget proposal that would have required physicians to pay upfront for this very expensive coverage and then be reimbursed.
- Insurance Reforms. Targeted health insurance reforms including requiring all New York state regulated health insurers to complete credentialing review within 60 days of the physician’s network participation application, as well as another measure to ensure all health insurers follow rules that limit excessive medical record requests.
- Insurance Coverage Expansion. Increasing New Yorkers’ eligibility for the Essential Plan with those with incomes up to 250% FPL; elimination of premiums for CHIP coverage for families up to 223% FPL; and one-year post-partum Medicaid coverage.
Importantly, as well, the final Health Budget bill also deleted Executive Budget proposals for which MSSNY had raised concerns, including:
- No Rx Prior Authorization. Imposing new prior authorization requirements for prescriptions written for patients covered by Medicaid and Medicaid Managed Care
- No Interstate Compact. Permitting New York to join the Interstate Medical Licensure compact
However, despite strong MSSNY opposition and other groups, the following proposals were included in the agreed upon Health Budget.
- Nurse Practitioners. Extending in statute for 2 years the current Executive Order provision that exempts Nurse Practitioners with more than 3,600 hours experience from having to maintain proof of collaborative relationships with physicians practicing in the same specialty;
- Additional Criteria for IDR. As part of a comprehensive proposal to update New York’s surprise bill law to incorporate mandatory elements of the federal No Surprises Act, while the provisions importantly eliminated the requirement for a patient to execute an Assignment of Benefits, it also included median in-network payment data as one of the express criteria to be considered by the Independent Dispute resolution entity in addition to the usual and customary charge of the physician and the particular expertise of that physician.
Also of note, the Budget allocates a pool of funds within the Department of Health to provide bonuses for health care employees who make less than $125,000 per year. Employers required to participate in the program include health care entities subject to a Certificate of Need process, or which have at least 20% of their patients covered under Medicaid. The bonuses range from $500 for a part-time worker to $3,000 for a full-time worker, over a 6-month period.
MSSNY staff is continuing its review of the many Budget provisions and will provide further updates.