Qualified employers include certain providers with at least one employee, and that bill for services under the Medicaid state plan or a home or community-based services (HCBS) waiver, providers that have a provider agreement to bill for Medicaid services provided or arranged through a managed care organization or a managed long term care plan, and certain educational institutions and other funded programs. These include certain providers, facilities, pharmacies, and school-based health centers licensed under the state Public Health Law, Mental Hygiene Law, and Education Law, as well as certain programs funded by the Office of Mental Health (OMH), Office for the Aging, Office of Addiction Services and Supports (OASAS), and the Office for People with Developmental Disabilities (OPWDD).
Submission details for qualified employers will differ based on if they are Medicaid or non-Medicaid employers.
Medicaid employers must be currently enrolled and payable through eMedNY and have an active MMIS ID to be able to submit on the HWB Program Portal. Providers who are not currently enrolled with eMedNY should visit the eMedNY website to learn more about how to enroll.
Qualified employees must be "front line health care and mental hygiene practitioners, technicians, assistants and aides that provide hands on health or care services to individuals". An employee is only qualified if they work for a qualified employer (as described above) and under an Eligible Worker Title.
Employees must meet the following eligibility criteria:
- Qualified employees must continuously employed by a qualified employer for the duration of at least one vesting period (see below)
- Qualified employees must have an employee title included on the list of Eligible Worker Titles;
- Qualified employees must not exceed an annualized base salary (excluding any bonuses or overtime pay) of $125,000, as evidenced by an Employee Attestation, which they must complete and return to their employer;
- Qualified employees can be full-time, part-time or temporary employees as well as independent contractors; and
- Qualified employees must not be suspended or excluded from the Medicaid program during the vesting period.
Qualified employers are required to submit claims for bonus payments for their qualified employees that meet the eligibility criteria (as described above) for participation in the HWB program.
Claims must be submitted for qualified employees within 30-days after the department publishes a vesting schedule for completed vesting periods, and thereafter within 30-days after the end of each additional vesting period. An employee vests if they have worked for the employer for the entire duration of a vesting period in an Eligible Worker Title. Upon employee vesting, Qualified employers must provide employees with an Employee Attestation Form and request this be returned to the employer prior to the claims due date of the claim (i.e., 30 days after vesting).
Qualified employers must pay bonuses to eligible employee no later than 30 days after the bonus amount is paid to the qualified employer.
Qualified employers will pay bonus amounts to qualified employees based on the number of hours worked during the vesting period as defined below:
- Qualified employees who work at least 20 hours but no more than 30 hours per week are eligible for a bonus of $500;
- Qualified employees who work at least 30 hours but no more than 35 hours per week are eligible for a bonus of $1,000; and
- Qualified employees who work at least 35 hours per week are eligible for a bonus of $1,500.
A qualified employee is eligible for up to two vesting periods per employer. The maximum any employee may receive is $3,000.
A vesting period is defined as a series of six-month periods between the dates October 1, 2021, through March 31, 2024. A vesting period must entail a consecutive six-month period. Employers will claim for all eligible employees whose 6-month vesting period ends within the defined vesting periods as outlined below.