Early intervention providers: Look the 'Gift Horse' in the mouth please.

I received this in email today:

Dear Colleague:

The NYS Department of Health (Department) is offering a one-time State safety net payment to Early Intervention providers, and will not proceed to implement the Preliminary Escrow Payment (PEP) proposal due to insufficient county participation.  

State safety net payments will be calculated as seventy-five percent of the value of claims submitted to insurers, with the exception of the medical assistance program, in the period April 1, 2013 through July 29, 2013 for which no known payment or denial has been received.  The State safety net payments will be reconciled commencing on October 1, 2013 by assigning to the Department twenty-five percent of each early intervention payment payable from the escrow account until such time as the State safety net payment is fully recovered.  The safety-net payment is a one-time payment made by the State.  All claims submitted by the provider, including those submitted to insurers in the period April 1, 2013 through July 29, 2013, will continue to be processed and paid in the normal course.  

Providers who wish to participate in the State safety net payment must execute an amendment to the Provider Agreement held with the Department.  If you are interested in participating in the safety net payment and would like a Provider Agreement Amendment sent to you, please e-mail the Bureau of Early Intervention at Provider@health.state.ny.us 

We request that you included in the body of the e-mail

“I request that the Department send to me the Provider Agreement Amendment in relation to the State safety-net payment and I authorize the Department to send the Provider Agreement Amendment by UPS overnight mail/signature required.”

Please include in the e-mail your full name, mailing address, and phone number.

The Provider Agreement Amendment must be signed, notarized, and returned before the State safety net payment can be issued.  Provider Agreement Amendments should be returned to the following address:

Bureau of Early Intervention
ESP Corning Tower, Room 287
Albany, NY  12237-0660
Attention: Provider Unit

The Department is requesting that you return the Provider Agreement Amendment as soon as possible after receipt to ensure timely safety net payment.  The Department will not accept requests for Provider Agreement Amendments after August 31, 2013.
Please contact the Bureau of Early Intervention at 518-473-7016 if you have any questions. 

Just so everyone is clear - THIS IS NOT A PAYMENT.  This is a loan for the money that is already owed to you.  You will have to pay it back - and there is no accompanying fix for the mess that they have made of the billing and claiming system.

How many people are in a work agreement where they have to take a loan from the other party as payment for services rendered?

Also, just like the original Provider Agreements, these are being crammed down the throats of providers with a demand for less than a two week turnaround.  That means that providers who are currently owed tens of thousands of dollars (and in some cases even more) will have to somehow make the legal determination that the agreement is legitimate and will have to make the accounting determination that it makes sense for their businesses - all with very little opportunity to study the issue fully.

As this is a "one time payment," how will this address the problem moving forward?  This 'solution' is another nail in the coffin of the Early Intervention Program because it does not solve any of the problems with the current system.  Will we see another LOAN to cover the period from August through November???  I can guarantee that there is no fix in the works that will make payments suddenly start flowing through this system.

Providers should be given adequate time to study the legal and accounting implications on our businesses before accepting such an agreement - and our State government should stop trying to throw band-aids on a gaping wound that they created.


Kristi DeLeurere said…
I am an early intervention provider in the state of West Virginia. I frequently hear complaints because we do not always get paid on time. Now I will tell my colleagues that at least we aren't working in New York!

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