Frequently Asked Questions

Specific Service Details

1. Are Preschool Supportive Health Services and School Health Services exempt?
2. Are Durable Medical Equipment (DME)/Medical supplies included in the 2% ATB Payment Reduction?
3. Does the 2% Across the Board Reduction apply to medical transportation, ambulance, ambulette and taxi services?
4. Does the 2% Across the Board Reduction apply to freestanding clinic services?
5. Does the 2% reduction apply to Case Management Services?
6. Is there an exemption for Nursing Services provided to Medically Fragile Children (under 21 years old)? What impact does the 2% ATB payment have on the 30% Medicaid Reimbursement Fee for Medically Fragile Nursing Services?
7. Are hearing aids supplies and services subject to the 2% Medicaid payment reductions?

Question Number	Question	Answer
1 | top |	Are Preschool Supportive Health Services and School Health Services exempt?	Yes, Supportive Health Services Program and Preschool Supportive Health Services Program settlement agreement and Payments to providers for Preschool Supportive Health Services and School Supportive Health Services under the current rates are EXEMPT from the 2% reduction.
2 | top |	Are Durable Medical Equipment (DME)/Medical supplies included in the 2% ATB Payment Reduction?	Yes, DME/medical supplies are subject to the 2% payment reduction. For a more in-depth list of services please view the non-institutional services Medicaid State Plan Amendment 11-72, page A(5), item Y at: New York State Medicaid Plan Proposed and Approved State Plan Amendments.
3 | top |	Does the 2% Across the Board Reduction apply to medical transportation, ambulance, ambulette and taxi services?	Yes, the 2% Across the Board Reduction applies to medical transportation, ambulance, ambulette and taxi services.
4 | top |	Does the 2% Across the Board Reduction apply to freestanding clinic services?	With the exception of Methadone Maintenance Treatment Programs, the 2% Across the Board Reduction does not apply to free-standing clinic services. However, due to a technical error, free-standing Article 28 clinics were mistakenly subject to a 2% check reduction for cycles 1786 (check release date Nov. 30, 2011) and 1787 (check release date Dec. 7, 2011). The reduction for cycle 1787 may not be a full 2% because the cycle ends on November 17, 2011 and the correction of the problem occurred on November 16, 2011 - so any claim processed after November 16, 2011 will not be affected by the 2% reduction (i.e., the provider will not see a reduction in the Dec. 7, 2011 check for that particular claim). DOH is in the process of calculating the value of inappropriate reductions and will refund that amount to the affected providers as soon as possible.
5 | top |	Does the 2% reduction apply to Case Management Services?	The 2% reduction applies to the following case management services: Target Group A&E (pregnant Women, medically needy women) Target Group C (HIV/AIDS) Target group F (Medically needy -economically/underprivileged) Target Group G (Early Intervention) Target Group M (1st time mothers/newborns methodology) In accordance with statute the following case management services are exempt from the reduction: Target Group B (Mental health) Target Group D (OMH-intensive mgmt region) Target Group D1 (OMH-intensive mgmt region) Target Group D2 (OMH-intensive mgmt region) Target Group H (OMH- Supportive case mgmt program) Target Group I (SSHSP & PSHSP)
6 | top |	Is there an exemption for Nursing Services provided to Medically Fragile Children (under 21 years old)? What impact does the 2% ATB payment have on the 30% Medicaid Reimbursement Fee for Medically Fragile Nursing Services?	There is no exemption for Nursing Services provided to Medically Fragile Children ( under 21 years old). The 2% ATB reduction does not affect the reimbursement methodology it is applied against the facility aggregate payment.
7 | top |	Are hearing aids supplies and services subject to the 2% Medicaid payment reductions?	Yes, hearing aids, supplies and services are subject to the 2% payment reduction. For a more in-depth list of services please view the non-institutional services Medicaid State Plan Amendment 11-72, page A(5), item Y at: New York State Medicaid Plan Proposed and Approved State Plan Amendments.