Thursday, May 23, 2013

Snort-worthy: NYS makes EI providers prove financial hardship before they will pay.


Here is some follow-up information for parents who are wondering why their children are on a waiting list for the NY State Early Intervention Program.  As indicated in earlier posts, there are fewer providers available to deliver services because many have left the early intervention system.  The program has directly contributed to a systematic destruction of small businesses operated by therapy providers around the state.  Those who remain are large agencies who are now beginning to be cash-strapped and others who happen to have a level of uncommon/savvy navigation skills that allows them to operate amidst the NY State-generated chaos.  Most early intervention providers have not seen payments since mid to late March and based on current projections they are only now beginning to trickle out partial payments for services that were delivered in the beginning of April.

If you read through the blog you will find a series of entries describing the disastrous implementation of a centralized billing system and absolute mismanagement of the early intervention program.  We received this email gem today, asking providers to write a letter begging for payment if they can prove financial hardship.  Here is the begging template that they want providers to use:



SAMPLE LETTER ONLY: PROVIDER MUST SUBMIT ON OWN LETTERHEAD
Date

Ms Deborah Martins/Mr.Anil Thomas
New York State Department of Health
Medicaid Financial Management
Corning Tower - Room 2739
Empire State Plaza
Albany, New York 12237-0016

Faxed Letter Date _________ to 518-473-8786
Original Mailed Overnight on ____________
MMIS PROVIDER I.D. ________________

Dear Ms Martins/Mr Thomas:
We are requesting an accelerated early release of the system check(s) and remittances dated ____________ and the amount(s) of $ _______________________.  The check(s) and remittances were scheduled to be released on _____________________ (date), and we are requesting approval of its release on _____________________ (date).   If approved, we will have the check and remittances (CHOOSE ONE)
_______ EFT
_______ Pick-Up in Menands New York          or
_______ Federal Express,            or
_______ First Class mail.


As a result of Medicaid billing problems, we cannot wait for the scheduled release date of the check for the following reason(s):

1. Explain the Medicaid Billing Problem,    AND

2. Cash flow or cash flow narrative which clearly shows why you cannot wait for the check to be released on the scheduled date.

As required, attached is a copy of a letter from our bank or financial institution which indicates we have been denied a line of credit, or, we have exhausted our current line of credit (i.e. relatively new line of credit or a “ceiling”  extension on a previous line of credit) and that we are ineligible for any  further assistance.
Sincerely,
xxxxxxxxxxxxxxxxxxxxxx

In order for early intervention professionals to be paid they are now requiring a cash flow statement submitted with the request for early release of payment that proves financial hardship. They state that Medicaid Financial Management will only make payments early if there is a valid and substantiated need for the payment. 

So here is my question back to NY State: Can I demand a cash flow statement and begging letter from you in order for me to send in my payroll taxes and quarterly income tax payments??

Shameful.

5 comments:

Your Therapy Source Inc said...

This is so ridiculous and frustrating. And people wonder why everyone is moving out of NY state!!! Although I work in the schools, I am sure this will soon trickle down to Medicaid related services for the school aged children. I have said this previously on your blog but have to repeat it. What makes me so frustrated is the window for neuroplasticity is wide open ages 0-3 years old so in NY state's brilliance they decide to basically close that window which could cost the state hundreds of thousands in later educational bills not to mention after 21 years of age! Makes no sense.

Anonymous said...

It is not surprising that the State would mandate a change in oversight and stop payments prior to having the new payment process operational.

It is called cash flow management for the incompetent and shysters.

Christopher Alterio said...

Sure, anonymous - the kind of cash flow management that requires people to exhaust lines of credit and assume massive debt before the State is willing to pay?

Of course the agencies can assign the letter writing task to their CFO, but what about all the small-fry independents or mom-and-pop providers? Are they supposed to send their bounced checks to the State or do we expect individual providers to take out loans so they can pay their mortgages?

Someone has to scream from the rooftops about this - and I hope plenty of people read this and understand that a large number of EI providers are NOT large agencies and they DO NOT have access to credit lines and they CAN NOT survive in this climate - and the State knows it because this is plain and simply oppressive.

Anonymous said...

6/30/13 Anonymous here again.

Perhaps you misunderstood my post.

I was referring to the State and all its associated incompetent departments and agencies, not the EI providers.

In fact, my wife is a Special Educator in Rockland County and she has not received any payments since March 2013.

We are now having to tap into our HELOC to pay the bills.

Still no word about when we can expect payment and nowhere to go with the issue or complaints.

Any ideas?

Christopher Alterio said...

My apologies, anonymous! Sometimes things get lost in the translation of written text and I misunderstood your post.

If you are the person I spoke to on the phone, then I hope I answered your questions! If not, or for anyone else in a similar situation, I recommend the following:

1. Go to http://www.health.ny.gov/community/infants_children/early_intervention/mailing_list.htm and sign up for the EI listserv. This will give you access to the information directly from the State if your agency is not sharing it with you.

2. Check your contract with your agency and see what it says exactly about your agreement re: payment.

3. Go to your agencies and ask for very open and honest communication about the agency's financial status, schedule for payments, etc.

4. Consult with an attorney as needed to help you plan an appropriate path forward.

I am getting emails from people who are in this situation where they are not getting paid and are not getting a lot of information from their agencies. I strongly suggest following the above steps to inform yourself and to develop open channels of communication with your agencies.