1% Across the Board Medicaid Payment Reductions

Effective for dates of service on or after January 1, 2020, through March 31, 2020, and each State Fiscal Year thereafter, all non–exempt Department of Health state funds Medicaid payments will be uniformly reduced by 1.0%. Medicaid payments that will be exempted from the uniform reduction include:

  1. Payments whereby Federal law precludes such reduction, including:
    • Federally Qualified Health Center services and Residential Health Clinics;
    • Indian Health Services and services provided to Native Americans;
    • Supplemental Medical Insurance – Part A and Part B;
    • State Contribution for Prescription Drug Benefit (aka Medicare Part D payments);
    • Any local share cap payment required by the Federal Medical Assistance Percentage (FMAP) increase legislation;
    • Services provided to American citizen repatriates; and
    • Hospice Service.
  2. Payments funded exclusively with federal and/or local funds include, but are not limited to, the following:
    • Upper payment limit payments to non-state owned or operated governmental providers certified under Article 28 of the NYS Public Health Law;
    • Certified public expenditure payments to the NYC Health and Hospital Corporation;
    • Certain disproportionate share payments to non-state operated or owned governmental hospitals; and
    • Services provided to inmates of local correctional facilities.
  3. Payments where applying the reduction would result in a lower FMAP as determined by the Commissioner of Health and the Director of the Budget will also be exempt.
  4. Other Payments that are not subject to the reduction include:
    • Payments pursuant to Article 32, Article 31 and Article 16 of the Mental Hygiene Law;
    • Required payments related to the School Supportive Health Services Program and Preschool Supportive Health Services Program;
    • Early Intervention;
    • Traumatic Brain Injury Waiver (TBI);
    • Nursing Home Transition and Diversion Waiver (NHTD);
    • Payments for services provided by Other State Agencies including Office of Children and Family Services, State Education Department, and the Department of Corrections and Community Supervision.
    • Physician Administered Drugs;
    • Court orders and judgments; and
    • Family Planning services.