Frequently Asked Questions

General

  1. What payments will be affected by the reduction?
  2. What services are exempt from the reduction in accordance with the statue?
  3. Will provider rates be revised to reflect the 2% Across the Board reduction?
  4. Will payees ever be reimbursed for these adjustments?
  5. If the primary insurer on a claim for clients with dual eligibility is Medicare or other third party payer, which are exempt from the reduction, is the copay and/or deductable paid by Medicaid exempt as well?
  6. Is there more detail available concerning what Medicaid programs are affected by the 2% payment reduction?
  7. Can I get a copy of the State Plan Amendments (SPA) affected by the 2% Across the Board payment reduction?
  8. Will Medicaid administrative payment to local social services districts be reduced by 2%?
  9. Where can I get a more detail list of specific services subject to the 2%?
  10. Will the 1099 tax form reflect the net pay or the actual check amount received because of the 2% reductions?
Question Number Question Answer
1

| top |		 What payments will be affected by the reduction? The following Medicaid payments will be reduced unless otherwise stated. Please note that the final 2011-12 State Budget (chapter 59 of the 2011 Laws) authorizes alternative methods to achieve proportionate savings.
To view payments affected by reduction, select here.
2

| top |		 What services are exempt from the reduction in accordance with the statue? To view services exempt from the reduction, select here.
3

| top |		 Will provider rates be revised to reflect the 2% Across the board reduction? No, provider rates of payment will not be revised. NYS statute requires that aggregate payments be uniformly reduced by the 2% amount. The reduction will not be at the claim level nor will any specific claim be adjusted.
4

| top |		 Will payees ever be reimbursed for these adjustments? In accordance with the statue payees will not be reimbursed for the 2% reduction.
5

| top |		 If the primary insurer on a claim for clients with dual eligibility is Medicare or other third party payer, which are exempt from the reduction, is the copay and/or deductable paid by Medicaid exempt as well? All Medicaid payments including copays and deductibles are affected by the 2% reduction unless specifically listed as exemptions.
6

| top |		 Is there more detail available concerning what Medicaid programs are affected by the 2% payment reduction? Yes, please refer to the Medicaid Redesign Phase 1 Work Plan link below for more information on implementation, and for a list of Medicaid programs affected by the 2% Payment reduction. The 2% Across the Board initiative is number 4651-B within the project work plan:Redesigning New York´s Medicaid
7

| top |		 Can I get a copy of the State Plan Amendments (SPA) affected by the 2% Across the Board payment reduction? Yes, copies of the approved 2011 state plan as well as the 2013 updated plans (13-20, 13-21 and 13-22) are available on the State plan ammendment website.
8

| top |		 Will Medicaid administrative payment to local social services districts be reduced by 2%? No, payments to local districts are not subject to the 2% reduction.
9

| top |		 Where can I get a more detail list of specific services subject to the 2%? For a more in-depth list of services please view the proposed and approved state plan amendments. The State plans are available on the Department´s Medicaid State Plan website. Please see SPA 13-20, 13-21 and 13-22 for 2013 a list may also be found on the 2% ATB Home page.
10

| top |		 Will the 1099 tax form reflect the net pay or the actual check amount received because of the 2% reductions? The 1099 tax form will reflect the check amount (the net pay minus the 2%)