Increases Medicaid reimbursement rates for certain behavioral health services provided to individuals under the age of twenty-one; directs that funds in the healthcare stability fund can be used for the funding of children's behavioral health outpatient rate increases.
Summary
A08600 would increase Medicaid reimbursement for certain children’s behavioral health services, focused on outpatient clinic services for individuals under age 21 provided under Articles 31 and 32 of the Mental Hygiene Law. Beginning April 1, 2026, the bill requires Medicaid payments for those outpatient behavioral health clinic services to rise by at least 35 percent, adds a care coordination fee of at least $7.50 per member per month where applicable, and applies a 3.2 percent trend factor. These increases are conditioned on approval of a plan by the Commissioner of Health and the Director of the Budget and must qualify for federal financial participation.
The bill also directs the Department of Health to submit state plan amendments to the federal Centers for Medicare and Medicaid Services by October 1, 2025, to implement comparable rate increases for home and community-based services and child and family support services. Those amendments would provide at least $45 million in increased funding, add the same care coordination fee where applicable, and apply the 3.2 percent trend factor for those services. In addition, the bill amends the State Finance Law to expressly allow the healthcare stability fund to be used to support children’s behavioral health outpatient rate increases.
Its practical impact would be to raise Medicaid payments for a set of child and youth behavioral health providers and to create a clearer funding pathway for those increases through the healthcare stability fund and federal Medicaid matching funds. The bill would affect state Medicaid financing, provider reimbursement rules, and the administration of behavioral health services for children and adolescents, particularly outpatient clinics and related home- and community-based service providers.
The general sentiment reflected in the bill text and caption is supportive of expanding funding for children’s behavioral health care and strengthening provider reimbursement. No committee transcript or vote history was provided, so there is no recorded public debate in the materials about opposition or amendments. Based on the structure of the bill, the main policy emphasis is on improving access and sustainability for youth behavioral health services through higher rates and dedicated funding mechanisms.
Notable points of contention, if any, would likely center on the fiscal cost to the Medicaid program and the state budget, the size of the mandated increase, and whether the required federal approvals and matching funds will be secured. Another possible issue is the use of the healthcare stability fund for these rate increases, which may raise questions about competing priorities for that funding source. However, no specific objections or supporters are identified in the provided materials.
Impact
The bill would amend the Social Services Law by creating a new section 364-k establishing minimum Medicaid reimbursement increases for outpatient behavioral health clinic services for individuals under 21, including a 35 percent rate increase, a $7.50 per member per month care coordination fee where applicable, and a 3.2 percent trend factor. It would also require the Department of Health to seek federal approval for similar increases for home and community-based services and child and family treatment/support services. The State Finance Law would be amended to permit use of the healthcare stability fund for children’s behavioral health outpatient rate increases, thereby expanding the funding tools available for Medicaid behavioral health reimbursement.
Sentiment
The bill appears generally favorable toward expanding and stabilizing funding for children’s behavioral health services. Its caption and text frame the measure as a reimbursement increase and funding support bill, suggesting a policy goal of improving provider payment levels and service availability. Because no committee discussion or vote record was provided, there is no documented opposition or support beyond the bill’s pro-funding structure.
Contention
The likely points of contention are fiscal and administrative rather than conceptual: the cost of a mandated 35 percent Medicaid rate increase, the additional care coordination fee, and the requirement to secure federal financial participation and CMS approval. Stakeholders concerned about state spending or Medicaid budget pressure may question the affordability of the measure, while providers and advocates for children’s mental health are likely to support it. The use of the healthcare stability fund for these increases could also be debated if lawmakers view that fund as needed for other health care priorities.
Same As
Increases Medicaid reimbursement rates for certain behavioral health services provided to individuals under the age of twenty-one; directs that funds in the healthcare stability fund can be used for the funding of children's behavioral health outpatient rate increases.
Increases Medicaid reimbursement rates for certain behavioral health services provided to individuals under the age of twenty-one; directs that funds in the healthcare stability fund can be used for the funding of children's behavioral health outpatient rate increases.
Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.
Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.
Establishes a core state behavioral health crisis services system, to be administered by the director of behavioral healthcare, developmental disabilities and hospitals.
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.