| Global Cap Forecast (Surplus)/Deficit |
$1,225.70 |
$1,390.80 |
|
| Signed Legislation |
|
|
$6.30 |
$6.70 |
| A.9542 Programs of All–Inclusive Care for the Elderly (PACE) Licensure |
6/27/23 |
Admin |
$0.30 |
$0.50 |
| A.299B Applied Behavioral Analyst Expansion |
10/1/22 |
Admin |
$6.00 |
$6.20 |
|
| Enrollment Update |
|
|
$0.00 |
$226.60 |
| Forecasted Enrollment Projections |
4/1/23 |
Admin |
$547.00 |
$139.60 |
| Financial Plan adjustment for COVID Enrollment |
4/1/23 |
Admin |
($547.00) |
$87.00 |
|
| Global Cap Index Update |
4/1/23 |
Admin |
($475.20) |
($694.00) |
|
| Global Cap (Surplus)/Deficit |
|
|
$756.80 |
$930.10 |
|
| Budget Actions |
|
|
($253.20) |
($687.40) |
|
| Hospital Actions |
|
|
$28.90 |
$63.30 |
| Additional SUNY Disproportionate Share Hospital (DSH) Support |
4/1/23 |
Admin |
$71.60 |
$106.00 |
| Voluntary Hospital Indigent Care Reduction |
4/1/23 |
Article VII |
($42.70) |
($42.70) |
|
| Nursing Home Actions |
|
|
$121.40 |
$121.40 |
| Removal of Nursing Home Staffing Pool |
4/1/23 |
Admin |
($93.50) |
($93.50) |
| Increase Nursing Home reimbursement by 6.5% (up to 7.5% total, subject to FFP) |
4/1/23 |
Article VII |
$204.80 |
$204.80 |
| Increase Assisted Living Program (ALPs) reimbursement by 6.5% |
4/1/23 |
Article VII |
$11.70 |
$11.70 |
| DOH Veterans Homes Investment |
4/1/23 |
Admin |
($1.50) |
($1.50) |
|
| Other Long-Term Care Actions |
|
|
($15.00) |
($122.00) |
| Increase Managed Long Term Care Partial (MLTCP) Medical Loss Ratio (MLR) to 89% |
4/1/24 |
Admin |
$0.00 |
($55.00) |
| Discontinue Managed Long Term Care (MLTC) Distressed Plan Pool |
4/1/23 |
Admin |
($15.00) |
($15.00) |
| Managed Long-Term Care Plans (MLTCP) Reforms |
1/1/24 |
Article VII |
$0.00 |
($52.00) |
|
| Managed Care Actions |
|
|
($213.20) |
($177.00) |
| Increase Mainstream Managed Care (MMC) MLR to 89% |
4/1/24 |
Admin |
$0.00 |
($12.00) |
| Delay Implementation of Undocumented Coverage Expansion for 65+ |
1/1/24 |
Article VII |
($171.90) |
$0.00 |
| Keep Pregnancy Coverage in Essential Plan |
1/1/24 |
Admin |
($41.30) |
($165.00) |
|
| Pharmacy Actions |
|
|
$73.70 |
($64.10) |
| NYRx Transition |
4/1/23 |
Admin |
($410.00) |
($547.80) |
| Support for Ryan White Centers (NYRx Reinvestment) |
4/1/23 |
Admin |
$30.00 |
$30.00 |
| FQHC and DTC Supplemental Payments (NYRx Reinvestment) |
4/1/23 |
Admin |
$135.00 |
$135.00 |
| Increase Hospital Inpatient reimbursement by 7.5% (NYRx Reinvestment) |
4/1/23 |
Article VII |
$318.80 |
$318.80 |
|
| Other Actions |
|
|
($249.10) |
($509.00) |
| Utilize Available Federal Funding |
4/1/23 |
Admin |
($219.10) |
($439.00) |
| Recalibrate Health Homes |
10/1/23 |
Admin |
($30.00) |
($70.00) |
| State of the State Investments |
|
|
$180.40 |
$416.40 |
|
| Expand Medicaid Buy-In for those with Disabilities |
1/1/25 |
Article VII |
$0.00 |
$60.00 |
|
| Expand Medicaid Coverage of Preventative Care |
|
|
$53.60 |
$105.20 |
| Expand nutritionist coverage to all populations |
10/1/23 |
Article VII |
$13.50 |
$18.00 |
| Increase in supportive housing funding |
10/1/23 |
Admin |
$15.00 |
$30.00 |
| Increase reimbursement rates for dental services to ensure access for all Medicaid members |
7/1/23 |
Admin |
$1.00 |
$1.40 |
| Increase Medicaid reimbursement for private practice dentists serving the IDD population |
7/1/23 |
Admin |
$0.30 |
$0.40 |
| Increase reimbursement for ambulatory surgery dental services for IDD population |
7/1/23 |
Admin |
$4.30 |
$5.70 |
| Establish Medicaid reimbursement for CDSMP (chronic disease self-management program) for arthritis management |
10/1/23 |
Article VII |
$0.10 |
$0.10 |
| Establish Adverse Childhood Experience screening reimbursement |
1/1/24 |
Admin |
$4.80 |
$19.20 |
| Ensure Medicaid coverage of Preventive Mental Health Services |
10/1/23 |
Admin |
$6.00 |
$12.00 |
| Statewide Medicaid coverage and Higher Reimbursement for Doulas |
1/1/24 |
Admin |
$2.30 |
$8.50 |
| Medicaid coverage of spinal muscular atrophy screening |
10/1/23 |
Admin |
$3.70 |
$6.40 |
| Increased vaccine administration fees to expand access to children |
7/1/23 |
Admin |
$2.70 |
$3.60 |
| Improve Access to Primary Care |
|
|
$46.00 |
$104.40 |
| Benchmarking primary care reimbursement to 80% of Medicare |
10/1/23 |
Admin |
$17.70 |
$35.30 |
| Promote Telehealth through eVisits |
10/1/23 |
Admin |
$0.80 |
$1.60 |
| Ensuring coverage of primary and urgent care in shelter system |
1/1/24 |
Admin |
$0.00 |
($2.40) |
| Increase reimbursement for School Based Health Centers |
4/1/23 |
Admin |
$1.40 |
$1.40 |
| Establish Medicaid reimbursement for Community Health Workers for more populations (including high-risk populations, maternity, children under 21, etc.) |
1/1/24 |
Article VII |
$8.70 |
$34.70 |
| Integrated Licensure Standards |
10/1/23 |
Admin |
$16.30 |
$32.70 |
| Eliminate Hepatitis C by Implementing Universal Hepatitis C (HCV) Screening |
4/1/23 |
Admin |
$1.00 |
$1.00 |
| Reimburse Screening for Congenital Syphilis during the 3rd Trimester |
4/1/23 |
Admin |
$0.20 |
$0.20 |
|
| Ensure Adequate Medicaid Reimbursement for Transportation Services by Increasing Reimbursement Rates |
7/1/23 |
Admin |
$13.70 |
$18.20 |
|
| Stabilize and Strengthen New York's Reproductive Health System |
10/1/23 |
Admin |
$8.30 |
$14.10 |
|
| Mental Hygiene SOTS Impacts |
|
|
$58.90 |
$114.40 |
| Expand the Comprehensive Psychiatric Emergency Program (CPEP) |
10/1/23 |
Admin |
$12.00 |
$24.00 |
| Expand the Assertive Community Treatment (ACT) Program |
10/1/23 |
Admin |
$4.60 |
$9.20 |
| Expand the Certified Community Behavioral Health Clinic (CCBHC) Program |
4/1/23 |
Article VII |
$3.50 |
$16.20 |
| Certified Community Behavioral Health Clinic (CCBHC) Indigent Care Program |
4/1/23 |
Article VII |
$11.30 |
$22.50 |
| Health Home Plus Expansion |
4/1/23 |
Admin |
$2.50 |
$2.50 |
| Expand Article 31 Clinic Capacity |
7/1/23 |
Admin |
$15.00 |
$20.00 |
| Increase reimbursement rates for School Based Mental Health Clinics |
10/1/23 |
Admin |
$10.00 |
$20.00 |
|
| Total Global Cap (Surplus)/Deficit |
|
|
$684.00 |
$659.10 |
|
| Enacted Adds |
|
|
($684.00) |
($659.10) |
| Adds |
|
|
$606.00 |
$106.00 |
| Financially Distressed and Safety-Net Hospitals Support |
4/1/23 |
Admin |
$500.00 |
$0.00 |
| Increase Hospital Outpatient reimbursement by 6.5% |
4/1/23 |
Article VII |
$76.10 |
$76.10 |
| Additional 1.5% OSA COLA |
4/1/23 |
Admin |
$29.90 |
$29.90 |
|
| Wage Actions |
|
|
($44.40) |
($381.60) |
| Wage Parity Savings |
1/1/24 |
Admin |
($115.00) |
($469.00) |
| Additional QIVAP Support |
4/1/23 |
Admin |
$70.60 |
$87.40 |
|
| Additional NYRx Reinvestment |
4/1/23 |
Admin |
$35.00 |
$35.00 |
|
| Avails |
|
|
($1,280.60) |
($418.50) |
| Prior Year State Funding Advance Recoveries |
4/1/23 |
Admin |
($177.60) |
$0.00 |
| Financial Plan Support of OSA COLA |
4/1/23 |
Admin |
($29.90) |
($29.90) |
| Available HCBS eFMAP |
4/1/23 |
Admin |
($214.00) |
$0.00 |
| Timing of Payments and Other Revisions |
4/1/23 |
Admin |
($859.10) |
($388.60) |
|
| Total Global Cap (Surplus) / Deficit |
|
|
$0.00 |
$0.00 |
|
| Minimum Wage Index Increase |
10/1/23 |
Article VII |
$52.70 |
$268.50 |
| Delay $1 Homecare Wage to 1/1/24 |
1/1/24 |
Article VII |
($96.50) |
$0.00 |
| Total Financial Plan Support for Minimum Wage (Outside the Global Cap) |
|
|
($43.80) |
$268.50 |
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