Skip to Main Content

Office of Mental Health

New York State Consolidated Budget and Claiming Manual Subject: Appendix DD OMH COPS/CSP/Level II COPS Medicaid Revenue Section: 54
For the Periods:
January 1, 2009 to December 31, 2009
July 1, 2009 to June 30, 2010
Issued: September 9, 2009

View Adobe Acrobat Version | Download Adobe Acrobat Reader

The following guidelines are to be used for the purpose of budgeting and claiming Medicaid Revenue from: (a) Comprehensive Outpatient Program (COPS), (b) Community Support Program (CSP), and (c) Level II COPS fee supplement.

General Instructions

  1. For Article 31 and D&TC providers, COPS, CSP, and Level II COPS revenue should be reported on the CBR and CCR on the cash basis of accounting consistent with Section 3. 0 of the CBR manual (the Methods of Accounting Section). This reporting requirement was implemented for the purpose of preventing discrepancies between the reserve amounts (overpayments) calculated by providers, and the revenue reconciliations calculated by the OMH.
  2. For Article 28 providers, COPS and CSP revenue should be reported on the CBR and CCR on the accrual basis of accounting.
  3. For all providers, COPS, CSP, and Level II COPS revenue should be reported on the core CFR schedules (CFR-1 through DMH-1) on the accrual basis of accounting in the column of the licensed outpatient program which generated the revenue up to the threshold limit.  COPS, CSP, and Level II COPS revenue received over the threshold limit must be reported on Line 39 - Other Non-GAAP Adjustments of the DMH-2.
  4. To assist providers in properly segregating and tracking their COPS/CSP/Level II COPS Medicaid revenue, and identify any revenue that was received in excess of the threshold, OMH has designed a worksheet to help aid in this process. The worksheet is located at the end of this appendix.

COPS

COPS providers have the potential to generate COPS revenue in excess of the COPS threshold (the COPS threshold represents the 110% COPS amount (110% of corridor eligible funding and 100% of non-corridor eligible funding (500, Non-COPS, Shared Staff) that can be retained by the provider on an annual basis)). You may receive your threshold amount from the county, the field office, or the OMH Rate Setting Unit. When COPS overpayments occur, they will be recovered by the State through the COPS overpayment recovery process by direct payment (a check) of the full amount to DOH or the 15% withhold method (a series of reductions that is no more than 15% of any Medicaid check). The recovery process is described in great detail in the letter DOH will send should a recovery take place. Therefore, it is in the best interest of all providers to monitor their COPS revenue collections, and set aside those amounts that will be recovered (amounts set aside for recoveries are also referred to as COPS reserves).

Budgeting on the CBR

  1. COPS revenue is to be budgeted on Line 17 - Medicaid of the DMH-2 in the column of the licensed outpatient program that is to generate the COPS revenue.
  2. COPS revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 15. 0 of the CBR manual (the DMH-3 Section). 
  3. COPS overpayments from prior years do not need to be included on the budget (but need to be included on the claim).

Claiming on the CCR

  1. COPS revenue is to be claimed on Line 17 - Medicaid of the DMH-2. Use the COPS line to record the COPS revenue.
  2. COPS revenue that was reported on Line 39 - Other Non-GAAP Adjustments of the previous year's DMH-2 is to be reported on Line 29 - Other Revenue of the current year's DMH-2.  Record the previous year's COPS reserves (revenue in excess of the threshold (overpayments) generated during previous local fiscal years that have not yet been recovered by the State) on the COPS Prior Years line.
  3. COPS reserves (revenue in excess of the threshold (overpayments) generated during the current local fiscal year plus any overpayments generated during previous local fiscal years that have not yet been recovered by the State) are to be reported on Line 39 - Other Non-GAAP Adjustments of the DMH-2.  Use the COPS reserve line to record the COPS reserve.
  4. COPS revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 24. 0 of the CFR manual (the DMH-3 Section).
  5. Providers are to continue to complete the CBR and CCR on a county-specific basis.  Providers who operate COPS programs that have locations in more than one county, or providers who operate COPS programs at locations in one county, but provide COPS services to residents of another county through a contractual arrangement, are to allocate COPS overpayments to the participating counties consistent with the ratio of the COPS threshold for the program type in that particular county to the agency's Total COPS threshold for that particular county.

CSP

CSP providers have the potential to generate CSP revenue in excess of the CSP threshold (the CSP threshold represents the 100% CSP amount that can be retained by the provider on an annual basis). You may receive your threshold amount from the county, the field office, or the OMH Rate Setting Unit. When CSP overpayments occur, they will be recovered by the State through the CSP overpayment recovery process by direct payment (a check) of the full amount to DOH or the 15% withhold method (a series of reductions that is no more than 15% of any Medicaid check). The recovery process is described in great detail in the letter DOH will send should a recovery take place. Therefore, it is in the best interest of all providers to monitor their CSP revenue collections, and identify those amounts that will be recovered (amounts set aside for recoveries are also referred to as CSP reserves).

Budgeting on the CBR

  1. CSP revenue is to be budgeted on Line 17 - Medicaid of the DMH-2 in the column of the CSP program for which the revenue is intended (and not in the column of the licensed outpatient program that is to generate the revenue).
  2. CSP revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 15. 0 of the CBR manual (the DMH-3 Section).
  3. CSP overpayments from prior years do not need to be included on the budget (but need to be included on the claim).

Claiming on the CCR

  1. CSP revenue is to be claimed on Line 17 - Medicaid of the DMH-2.  Record the revenue on the CSP line.
  2. Please note: It is the responsibility of (a) the LGU (in the case of CSP programs that are funded through the State aid approval letter), or (b) the direct contract provider (in the case of CSP programs funded through a direct contract between the State and the provider), that the CCR is submitted to ensure that the CSP revenue is reported in the column of the CSP program for which the revenue is intended. In the case of providers who receive CSP revenue for CSP programs funded through both the approval letter and a direct contract, it is the responsibility of the direct contract provider to inform the LGU of the proper amount of CSP revenue that is to be reported in the columns of the CSP programs funded through the approval letter).
  3. CSP revenue that was reported on Line 39 - Other Non-GAAP Adjustments of the previous year's DMH-2 is to be reported on Line 29 - Other Revenue of the current year's DMH-2.  Record the previous year's CSP reserves (revenue in excess of the threshold (overpayments) generated during previous local fiscal years that have not yet been recovered by the State) on the CSP Reserve Prior Years line.
  4. CSP reserves (revenue in excess of the threshold (overpayments) generated during the current local fiscal year plus any overpayments generated during previous local fiscal years that have not yet been recovered by the State) are to be reported on Line 39 - Other Non-GAAP Adjustments of the DMH -2.  Providers who receive CSP revenue in more than one type of outpatient program shall identify the CSP overpayments and shall report these overpayments in the program(s) where the overpayment has been received.
  5. CSP revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 24. 0 of the CFR manual (the DMH-3 Section).

Level II COPS

Level II COPS providers have the potential to generate Level II COPS revenue in excess of the Level II COPS threshold (the Level II COPS threshold represents the 100% Level II COPS amount that can be retained by the provider on an annual basis). You may receive your threshold amount from the county, the field office, or the OMH Rate Setting Unit. When Level II COPS overpayments occur, they will be recovered by the State through the Level II COPS overpayment recover process by direct payment (a check) of the full amount to DOH or the 15% withhold method (a series of reductions that is no more than 15% of any Medicaid check). The recovery process is described in great detail in the letter DOH will send should a recovery take place.  Therefore, it is in the best interest of all providers to monitor their Level II COPS revenue collections, and set aside those amounts that will be recovered (amounts set aside for recoveries are also referred to as Level II COPS reserves).

Budgeting on the CBR

  1. Level II COPS revenue is to be budgeted on Line 17 - Medicaid of the DMH-2 in the column of the licensed outpatient program that is to generate the Level II COPS revenue.
  2. Level II COPS revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 15. 0 of the CBR manual (the DMH-3 Section).
  3. Level II COPS overpayments from prior years do not need to be included on the budget (but need to be included on the claim).

Claiming on the CCR

  1. Level II COPS revenue is to be claimed on Line 17 - Medicaid of the DMH-2.  Record the revenue on the Level II COPS line.
  2. Level II COPS revenue that was reported on Line 39 - Other Non-GAAP Adjustments of the previous year's DMH-2 is to be reported on Line 29 - Other Revenue of the current year's DMH-2.  Record the previous year's Level II COPS Reserves from Line 39 - Other Non-GAAP Adjustments (revenue in excess of the threshold (overpayments) generated during previous local fiscal years that have not yet been recovered by the State) on the Level II COPS Prior Years line.
  3. Level II COPS reserves (revenue in excess of the threshold (overpayments) generated during the current local fiscal year plus any overpayments generated during previous local fiscal years that have not yet been recovered by the State) are to be reported on Line 39 - Other Non-GAAP Adjustments of the DMH-2.
  4. Providers are to continue to complete the CBR and CCR on a county-specific basis. Providers who operate Level II COPS programs that have locations in more than one county, or providers who operate Level II COPS programs at locations in one county, but provide Level II COPS services to residents of another county through a contractual arrangement, are to allocate Level II COPS overpayments to the participating counties consistent with the direction provided in Section 15. 0 of the CBR manual (the DMH-3 Section).  
  5. Level II COPS revenue is to be allocated on the DMH-3 with all other Medicaid revenue consistent with the direction provided in Section 15. 0 of the CBR manual (the DMH-3 Section).

Claiming and Reporting Worksheet For COPS, CSP, and Non-COPS

  Example: Enter your Amounts Here: Description
COPS Threshold   $100,000   Amount provided by the county, field office, or the OMH rate setting unit.
CSP Threshold   $100,000   Amount provided by the county, field office, or the OMH rate setting unit.
Level II -COPS Threshold   $0   Amount provided by the county, field office, or the OMH rate setting unit.
Line 17 - Medicaid:        
COPS a) $120,000   Current year COPS revenue minus any COPS recoveries made in the current year.
CSP b) $40,000   Current year CSP revenue minus any CSP recoveries made in the current year.
Level II COPS c) $0   Current year Non-COPS revenue minus any Level II COPS recoveries made in the current year.
Total: a + b + c   $160,000   Equals the total Medicaid Revenue
Line 29 - Other Revenue:        
CSP Reserve Prior Year a) $20,000   CSP Reserve from Line 39 - Other Non-GAAP Adjustments from prior year
COPS Prior Year b) $20,000   COPS Reserve from Line 39 - Other Non-GAAP Adjustments from prior year
Level II COPS Prior Years c) $0   Level II COPS Reserve from Line 39 - Other Non-GAAP Adjustments from prior year
Total: a + b + c   $40,000   Equals total prior year reserves from previous years Line 39 - Other Non-GAAP Adjustments (overpayments)
Line 39 - Other Non-GAAP Adjustments:        
CSP Reserve a) $20,000   Current year CSP overpayment plus prior year CSP reserve not yet recovered
COPS Reserve b) $40,000   Current year COPS overpayment plus prior year COPS reserve not yet recovered
Level II COPS Reserve c) $0   Current year Level II COPS overpayment plus prior year Level II  COPS reserve not yet recovered
Total: a + b + c   $60,000   Equals current year overpayments plus any prior year reserves not yet recovered

Comments or questions about the information on this page can be directed to the Community Budget & Financial Management (CBFM) Group.