BULLET IN NEW YORK STATE PSYCHIATRIC ASSOCIATION 2012, Vol. 56, #1 • Bringing New York State Psychiatrists Together Albany Report Medicaid Redesign & the Public By Richard J. Gallo, Barry B. Perlman, MD and Jamie Papapetros Mental Health System in NYS By Barry B. Perlman, M.D. Governor Lays Out Agenda for 2012 Legislative Session in State of State Address n my last piece for the NYSPA changed to PROS (Personalized Basking in the glow of the successes of the 2011 Legislative Session, Governor Bulletin I presented an overview of Recovery Oriented Services) programs; Cuomo delivered his second State of the State address – an ambitious roadmap Ithe attack on Medicaid, including transition of the NYS Medicaid formu - that largely focused on revitalizing the State’s economy and spurring job creation. mental health services, taking place lary to a series of Medicaid HMO based Calling it a blueprint for a New New York, the Governor outlined several specific across the nation. I expressed my belief formularies and a limited formulary for agenda items for the 2012 Legislative Session including: that given New York State’s expendi - those enrollees remaining in the • Closing a $2 billion budget deficit without any new taxes or fees. tures on Medicaid, which are far higher Medicaid Fee For Service (FFS) system than any other state, reductions were and elimination of the long standing • Continuing the consolidation of State agencies and authorities, as recommend - necessary although not welcome in the ed by the Governor’s Spending and Government Efficiency (SAGE) statutory requirement that when a dif - current dismal economic climate. We ference exist between a physician and a Commission, including the merger of the Office of Mental Health and the are fortunate that the changes in New Office of Alcoholism and Substance Abuse Services. Details of this re-organiza - Medicaid formulary, the “physician pre - York are being implemented in a vails”; the process of moving all of tion are expected to be unveiled in the Governor’s budget proposal for 2012-13. thoughtful manner meant to preserve • Passage of legislation establishing an insurance exchange pursuant to the federal those covered under the Medicaid FFS the gains made in the delivery system in system to a fully managed system; initi - healthcare reform law. recent years and, perhaps, even to ation of a process of creating Health improve that system of care. The complete text of the State of the State address can be downloaded at: Homes to provide varying intensities of http://www.governor.ny.gov/assets/documents/Building-a-New-New-York-Book.pdf The 2011 New York State budget includ - case management for a “high user” pop - ed wide ranging budget reductions to ulation composed of persons with seri - MEDICAID REDESIGN TEAM since its inception.” the Medicaid program. These changes ous and persistent mental illness SUBMITS FINAL REPORT: The last meeting of the MRT was held included but were not limited to: a 2% (SPMI) and/ or chronic medical dis - Work Groups’ Recommendations on 12/13/11 to receive and approve the reimbursement cut for hospitals, includ - eases. Advance to the Governor recommendations of the remaining four ing most mental health services, both The work of fostering the wide ranging Established by Executive Order on of the nine Work Groups: inpatient and outpatient; creation of thresholds for outpatient mental health transformation of the mental health sys - January 5, 2011, the Medicaid Redesign • Basic Benefit Review Work Group tem and the Medicaid system more Team (MRT) concluded its year-long • Workforce Flexibility and Change of and drug & alcohol visits which when exceeded result in automatic reimburse - broadly is being developed under the assignment and issued its final report Scope of Practice Work Group aegis of the semitransparent/semi on 12/31/11, concluding that the rec - • Payment Reform Work Group ment reductions; reduction of reim - bursement for Continuing Day opaque MRT (Medicaid Redesign Team) ommendations, if implemented, consti - • Affordable Housing Work Group process and its Behavioral MRT sub - tute “the most significant overhaul of Treatment Programs (CDT) to the the New York State Medicaid program [See Albany Report on page 5] extent that many were shuttered or [See Medicaid Redesign on page 6] Legislative Brunches Fall NYSPA Council Meeting By Rachel A. Fernbach, Esq. By Rachel A. Fernbach, Esq. he New York County District duced Carol Bernstein, M.D., APA he New York Branch of the APA hosted its 13th Immediate Past-President; Glenn State T Annual Citywide Josef Weissberg Martin, M.D., NYSPA President; and T Psychiatric Legislative Breakfast on December 4, Jack Hirshowitz, M.D., Chair of the Association held its 2011, at the New York Academy of NYCO Legislative Committee. Finally, annual Fall NYSPA Medicine in New York, New York. One Dr. Katz introduced New York State Council Meeting on week later, the Psychiatric Society of Assembly Members David Weprin (D- Saturday, October 15, Westchester hosted its 25th Annual Queens) and Brian Kavanagh (D- 2011 at the New York Legislative Brunch on December 11, Manhattan). LaGuardia Airport Marriott Hotel in 2011, at the Crowne Plaza Hotel in The members of the panel discussed a East Elmhurst, New White Plains, New York. variety of issues regarding proposed New York City Breakfast York. Glenn Martin, changes to the Medicaid managed care M.D., NYSPA The planning committee for the New system, which will move all Medicaid President, called the York City event adopted a new and beneficiaries into a managed care plan. meeting to order and exciting format this year. The organizers The Medicaid program plans to estab - welcomed Council invited a panel of experts to discuss pro - lish behavioral health organizations guests. After the call James Nininger, M.D., Seeth Vivek, M.D., M. Mercedes Perez- posed changes to the Medicaid managed (BHOs) which will coordinate care for to order, various Rodriguez, M.D., Aaron Satloff, M.D., Russell Denea, M.D. care system and the expected impact on individual with serious and persistent members of the NYSP-PAC financial statement for individuals with serious and persistent mental illness (SPMI), traditionally high Council provided reports. January-October, 2011, comparisons mental illness. The panel included New volume users of the Medicaid system. Richard Altesman, M.D., NYSPA for the same time period for 2010 and York State Assemblymember Richard As individuals are transitioned out of Secretary, presented minutes from the 2009, and the list of contributors so far Gottfried (D-Manhattan); Michael fee-for-service Medicaid, mental health March 26, 2011 meeting of the NYSPA this year. Hogan, Ph.D., Commissioner, NYS professionals must work to ensure that Council, which were approved. NYSPA In his President's Report, Dr. Martin Office of Mental Health; Andrea Cohen, access to medically necessary care, treat - Treasurer Jeffrey Borenstein, M.D. pre - provided an update on a variety of Director of Health Services, Office of the ment and medications are not compro - sented NYSPA financial statements for Council issues. He confirmed that no Mayor, New York City; and Ann mised. January-September 2011 with a com - additional cuts have been made to the Sullivan, M.D., Senior Vice President, The panel discussed the need to preserve parison for the same period for 2010 New York State Delegation to the APA Queens Health Network, NYCHHC. safety net institutions as well the and 2009. Dr. Borenstein reported that Assembly and that the number of rep - the $15 dues increase slated for 2012 The event was moderated by Barry [See Legislative Brunches on page 4] resentatives remains at 14. Dr. Martin Perlman, M.D., Chair should begin to have an impact in the announced that the Assembly Speaker, of the NYSPA next billing cycle. He also noted that Ann Sullivan, M.D., has formed a spe - Committee on the new APA credit card installment cial Planning Committee to review the Legislation and NYSPA payment plan for dues has affected the structure of the Assembly and deter - Past-President. timing of anticipated revenues. Finally, mine whether it is best suited to repre - Dr. Borenstein noted that due to very Craig Katz, M.D., sent and serve the needs of APA mem - low CD rates, NYSPA has decided not bers. Dr. Martin noted that he was President of the New to reinvest any funds at this point and York County District pleased to have been appointed a will wait to see if rates shift in the near member of this committee. Branch welcomed future. everyone and shared a Dr. Martin announced that NYSPA and Budget Committee Chair Aaron Satloff, memory of Josef MSSNY have collaborated to improve M.D. presented the 2012 NYSPA budg - membership in both organizations and Weissberg. He wel - et, which included very little change comed Richard that MSSNY has agreed to offer from the prior year. The Council voted reduced dues for the first two years of Stagnato from PRMS to adopt the 2012 budget. Edward and thanked PRMS for membership for any APA member who Gordon, M.D., Chair of the Political joins MSSNY. its support of today's Action Committee, presented the event. Dr. Katz intro - Panelists at the NYC event [See Council Meeting on page 3] THE BULLETIN FROM THE EDITOR’S DESK... By Jeffrey Borenstein, MD NEW YORK STATE his edition of the events, including a panel Contest. The Area II Trustee Report PSYCHIATRIC Bulletin focuses on a of experts discussing highlights key issues addressed at ASSOCIATION T number of key leg - changes to Medicaid. We the APA Board of Trustees meeting. islative and regulatory also have an article which We are also pleased to announce issues. The Albany Report examines Medicaid Re- that Barry Perlman, M.D., NYSPA Editorial Board reviews issues related to design.