Title: Section 86-12.3 - Utilization limits on OASAS licensed clinics

Effective Date

08/12/2015

86-12.3 Utilization limits on OASAS licensed clinics.

(a) Effective for services provided on and after April 1, 2011 Medicaid payments for outpatient alcoholism and substance abuse services provided in outpatient clinic facilities licensed by the Office of Alcoholism and Substance Abuse Services (“OASAS”) pursuant to article 32 of the Mental Hygiene Law shall reflect applicable provisions of regulations promulgated by OASAS and shall be adjusted relative to 2009 service utilization and payment levels in accordance with the following:

(1) The seventy-sixth through ninety-fifth visits in a state fiscal year shall be subject to a 25% reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 32 of the Mental Hygiene Law or regulations promulgated thereunder.

(2) Visits in excess of the ninety-five visits in a state fiscal year shall be subject to a 50% reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 32 of the Mental Hygiene Law or regulations promulgated thereunder.

Volume

VOLUME A-2 (Title 10)

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