Part AA - Commercial Rate Mandate Survey
The NYS Council has been hearing from some of our members that are trying to engage with commercial insurers (where the provider is currently not 'in network' with the plan/s) who are stating to the provider that the insurer will not talk about extending in network status to the provider until such time as the Department of Financial Services (DFS - oversees commercial plans in NYS) puts out written guidance to the insurers re: Part AA - the new commercial rate mandate.
There are other providers who are in network with a commercial plan/s that are trying to amend existing contracts with the insurer to include some language in the contract that memorializes the major components of the new commercial rate mandate however only some of the plans are agreeing to amend the existing contract - presumably until the state puts out formal guidance on Part AA.
As you know, the NYS Council has been aggressively advocating with state officials for the Department of Financial Services in concert with OMH and OASAS to do far more than merely issue an FAQ document and host a webinar to review the FAQs re: the new commercial rate mandate sometime in October (this is the current plan). FAQs do not suffice. We have raised this problem with the Governor's Office twice to date with another meeting coming up on Friday and we have been very urgent in our requests to OMH and OASAS for assistance to move DFS to take formal action by issuing a DFS Notice or Circular to the impacted health plans in NYS re: the new commercial mandate. Unfortunately, some plans are telling providers they won't do anything until they receive formal guidance from DFS re: the new mandate.
To help us quantify the extent of the problems our members are currently experiencing PLEASE share your responses to the following questions by end of business tomorrow (Thursday) so we can use this information (completely confidential and in the aggregate only) to advocate on your behalf: