Attestation Deadline for New York Medicaid PCMH Incentive Increase

AAFCPAs would like to make FQHC clients aware that the 2024-2025 state budget approved a Patient-Centered Medical Home (PCMH) incentive increase that provided additional funding to health centers. These payments, which were retroactive to April 1, 2024, included $2 per member per month (PMPM) for adult Medicaid patients and $4 PMPM for children under the age of 21.  We advise that health centers continue to monitor and implement requirements in order to receive these payments.

Effective April 1, 2025, these incentive payments will be contingent upon health centers completing an attestation by March 31, 2025, confirming that they established workflows to connect patients to Social Care Networks (SCNs). SCNs provide enhanced Health-Related Social Needs (HRSN) services to Medicaid patients, including housing, nutritional support, care coordination, and transportation.

There are three acceptable options for these referral workflows:

• Connecting patients to the regional SCN(s) via referral provided to the patient,
• Connection directly with the SCN platform or through a regional Qualified Entity to submit Accountable Health Communities Health Related Social Needs screenings and referrals for Medicaid members, or
• Connection with SCNs in another agreed-upon way.

Health centers must submit a separate attestation for each physical location. However, it is possible to submit for multiple sites at once. Be mindful that late submissions will delay payment; for example, submitting on April 15, 2025, means the increased payments would be effective on May 1, 2025 and there would be no incentive payments for the month of April 2025.

Key Details

• Deadline: The attestation must be submitted by March 31, 2025, to avoid delays.
• Payment Timing: Late submissions will result in forfeited payments.
• Workflow Requirements: Ensure your health center has established at least one referral method to SCNs.

AAFCPAs helps clients navigate the attestation process and ensure compliance with new requirements. Contact AAFCPAs to discuss how we may support your organization in meeting these deadlines and securing the available incentive payments.

How We Help

AAFCPAs’ Healthcare Practice helps FQHCs comply with financial, operational, and regulatory requirements including Medicaid funding changes and filing requirements. With more than 50 years of experience, we advise on government funding compliance, internal controls, and reimbursement strategies. AAFCPAs assists health centers in meeting the new SCN attestation requirements by evaluating referral workflows, ensuring accurate and timely submissions, and identifying financial implications related to the PMPM incentive increase.

If you have questions, please contact Matthew Hutt, CPA, CGMA, Partner at 774.512.4043 or mhutt@aafcpa.com—or your AAFCPAs Partner.