1.5% Across the Board (ATB) Medicaid Payment Reductions

The New York State Health Department announced on May 19th, 2020 that it was reducing Medicaid payments by 1.5%, effective for dates of service April 2, 2020 and after. With a 1% cut having already been imposed for claims with dates of service between January 1, 2020 and April 1, 2020, physicians can expect that their payments will be 0.5% less for claims with dates of service 4/2/20 and after, when compared to claims with dates of service between 1/1/20-4/1/20.  The announcement from the Department of Health notes the cuts are not applicable to physician administered drugs.

“Effective for dates of service on or after April 2, 2020 and each State Fiscal Year thereafter, all non-exempt Department of Health state funds Medicaid payments will be uniformly reduced by 1.5%. For services subject to the 1.5% reduction, all fee-for service payments will receive a decrease to Medicaid checks and/or Electronic Funds Transfers for dates of services on or after April 2, 2020. Conversely, managed care payments to health plans will be reduced through a 1.5% reduction to premium rates effective April 2, 2020. Remittances will reflect the prospective 1.5% reduction (appearing as an “FC2” recoupment) starting in cycle 2231, which has a check release date of 06/10/2020 (distressed providers will have a check release date of 05/27/2020). Retroactive adjustments to previously submitted claims with dates of service spanning April 2, 2020 through May 13, 2020 will be made at a future date.

Please Click Here to read the full provider notice.”

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