NYS Identifies Targeted Areas for Proposed Medicaid Cuts Amidst Angry Protests
NYAPRS E News February 18, 2020
NYAPRS Note: Two major themes have emerged from the first two meetings of the Medicaid Redesign Team II that has been tasked with finding $2.5 billion in Medicaid savings to propose a few weeks before New York’s state budget must be enacted on April 1.
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Advocates for Medicaid and New Yorkers with disabilities came out in force at last week’s meetings in Albany and New York City, enraged about a process that excluded advocates and consumer stakeholders from sitting on the group and that gave as little as one day’s notice to attend and possibly testify. NYAPRS strongly agrees and is equally concerned about the lack of lead time to sign up for TODAY’S NOON MEETING IN ROCHESTER.
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NYS Medicaid Director Donna Frescatore has disclosed 6 areas that the state has recommended for reductions including:
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long-term and personal-care services for people with chronic conditions and disabilities…read that in part as the Consumer Director Personal Assistance program that NYAPRS strongly supports. Thankfully, CDPAP’s leading advocate Bryan O’Malley has been appointed to the state’s newly announced workgroup on Long Term Care (https://www.health.ny.gov/health_care/medicaid/redesign/mrt2/docs/ltc_advisory_group.pdf).
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state payments to distressed hospitals
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prescription drug costs
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taxi livery and medical transportation use
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health homes and care management for people with complex conditions and diseases, another issue of great concern to NYAPRS
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fraud, waste and abuse
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NYAPRS is also urging the state to continue to exempt mental hygiene services from any cuts, as it did earlier this year.
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Individuals and groups can provide additional comments and recommendations by this Friday at https://www.surveymonkey.com/r/Medicaid_Redesign_II_Pulic_Proposal_Survey
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Cuomo’s Medicaid Task Force Holds First Meeting, Faces Backlash From Advocates
By Denis Slattery New York Daily News February 11, 2020
ALBANY — A panel tasked with finding ways to overhaul the state’s health care system and save $2.5 billion in Medicaid costs met for the first time Tuesday in the state capital.
The 21-member Medicaid Redesign Team II, comprised of state officials and industry insiders, has roughly seven weeks to tackle the gargantuan task of trimming billions from a program that serves roughly six million poor and elderly New Yorkers.
Gov. Cuomo convened the task force as part of his plan to tackle the state’s ballooning Medicaid costs, which have led to a projected $6 billion budget gap.
“It’s important that we do this, do it thoughtfully, and do it well, so that we can continue to maintain and sustain the Medicaid program,” said Michael Dowling, CEO of Northwell Health and co-chair of the panel. “This is to protect the Medicaid program for the future and so that we can make changes to it to preserve it.”
Advocates, fearing widespread cuts and restructuring of the program, rallied outside the public meeting before briefly interrupting Cuomo budget director Robert Mujica as he recapped the work of the last MRT with chants of “We are watching, no Medicaid cuts.”
Some blasted the process as a sham, voicing displeasure over the short timeframe, the makeup of the advisory group and the high number of health care executives on the dais.
“Governor Cuomo is not to be trusted regarding this non-transparent MRT process,” said Charles King, CEO of the non-profit Housing Works. “The MRT itself is loaded with self-interested insiders who will do the governor’s bidding as long as their ox isn’t gored. And the Legislature has been completely shut out of the process, being asked to approve the results sight unseen or face massive across the board cuts. This is not how you improve health care for New Yorkers. And it is undemocratic at its core.”
Dowling announced the MRT will host two more public meetings before issuing its final recommendations. One will be held in New York City on March 2, while the final one will take place sometime “Mid-March.”
Lawmakers will then have a limited time to analyze the results as they prepare for the budget deadline on April 1.
A separate sub-committee will be convened to look at long-term care, which Mujica said is responsible for about half of the recent growth of the program.
Spending on “Managed Long Term Care” ― private insurance plans contracting with Medicaid meant to help people receive care at home rather than nursing homes — tripled between 2013 and 2019, a $4.8 billion increase, the administration has said.
Mayor de Blasio was in town a day earlier, decrying another part of Cuomo’s Medicaid proposal.
De Blasio warned that the city could see the closure of 19 neighborhood health clinics, the end of popular after-school programs, and more than 1,300 doctors and nurses possibly losing their jobs under Cuomo’s plan to make the city and counties pay more in Medicaid costs if the program’s growth can’t be reined in.
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Protests Overshadow Policy at Medicaid Redesign Meeting
Crain’s Health Pulse February 18, 2020
Gov. Andrew Cuomo’s Medicaid Redesign Team tipped their hands last week to which part of the health care program will likely go under the knife, but at a hearing on Friday the public let them know that they had already lost patience.
Long-term care and the consumer-directed personal assistance program, distressed hospitals, prescription drugs, transportation and health homes were all cited as areas that need a “course correction.”
Friday’s forum, which was the first opportunity for the public and the health care sector to respond to the suggested cuts, was largely overshadowed by irritation that the state Department of Health gave less than 24 hours’ notice for the time and location of the event.
Protesters briefly interrupted the meeting, which was held at the Fashion Institute of Technology in Manhattan, to call attention to the last-minute notification and raise concerns that the Cuomo administration already knows how it plans to reduce Medicaid spending and is not interested in receiving input from the public.
“This commission is a sham,” Anthony Feliciano, director of the Commission on the Public’s Health System, said as protesters rose from their seats to link hands at the front of the room. “To get less than 24 hours’ notice is unacceptable.”
Several Medicaid beneficiaries with physical disabilities spoke and explained their difficulty in getting to the meeting.
“There should be no decisions without us,” said Jessica De La Rosa, a Medicaid beneficiary and advocate for the Brooklyn Center for Independence of the Disabled.
She said that she and her partner have relied on the Consumer Directed Personal Assistance Program to help them live independently in the community.
The redesign team must make recommendations to save the state $2.5 billion by mid-March.
The hearing was the first opportunity organizations dependent on state Medicaid funding had to make the case that their corner of the industry should be spared.
Jessica Diamond, chief population health officer for HRHCare, said the redesign team needs to remove the health home program from its list of areas for savings. About 20,000 people are enrolled in HRHCare’s health home, making it the largest in the state. Health homes are groups of health care providers who manage the care of people with conditions such as serious mental illnesses or HIV/AIDS.
Diamond noted that health homes’ clients are at a high risk to need expensive hospitalization and that the program has been shown to decrease homelessness, depression, diabetes outcomes and patients’ adherence to medication regimens.
“The work on the health home program is of the utmost importance and must be preserved,” she said.
Amy Dorin, president and CEO of the Coalition for Behavioral Health, made a similar argument, explaining that behavioral health providers save money for Medicaid by keeping people out of hospitals. “It’s critical behavioral health services remain exempt from any cuts,” she said.
T.K. Small, a member of the Medicaid Redesign Team and a beneficiary with physical disabilities himself, told attendees that he still had faith in the process—even though the short notice given for the meeting led him to miss the first hour.
“I’m committed to the process,” he said. “I’m committed to the folks in New York state who use Medicaid for remaining in the community.”
The next public meeting will be held in Rochester today at noon.
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Protest Disrupts First Meeting Of Cuomo’s Medicaid Savings Panel
In Difficult Budget Year, Protestors Urge New York To Spare Medicaid, Tax The Rich
By Bethany Bump Albany Times Union February 11, 2020
ALBANY — A group convened by Gov. Andrew Cuomo to identify billions of dollars worth of Medicaid savings for the state met for the first time Tuesday, providing some insight into how the panel intends to arrive at its recommendations.
Chaired by Michael Dowling, president and CEO of Northwell Health, and Dennis Rivera, former head of SEIU Healthcare, the 21-member panel will meet just three times before it must submit a list of recommendations to the governor and Legislature in mid-March for consideration in the state budget due April 1.
Its task: Find $2.5 billion in savings for the 2021 state budget and recurring savings for future-year budgets, and do so without affecting local governments and beneficiaries, according to directives handed out by Cuomo.
“It’s obvious to everybody sitting around the table here that this is a complex task,” said Dowling at the group’s first meeting at the Albany Capital Center. “This is difficult. The time is short. And issues are complicated. But we have a major obligation to put every effort into coming up with the right resolutions here. We have to keep in mind the importance of the beneficiaries that benefit from Medicaid, the importance of Medicaid as a program itself.”
As a visible reminder of the sensitive task ahead of it, the panel was met by protesters both inside and outside the center Tuesday. Some were in wheelchairs, and many held signs with messages such as “You cut Medicaid, you kill me.” They urged leaders to balance the state budget — which faces a $6.1 billion gap in the next fiscal year — by taxing the rich, not by cutting Medicaid, a program that provides health coverage to roughly 6 million poor and disabled New Yorkers.
“Medicaid is a New York success story,” said Lara Kassel, coordinator of Medicaid Matters, a statewide coalition representing beneficiaries, before the meeting. “We have more people covered, we have more people living independently in their own homes, more people living without the fear of economic ruin thanks to Medicaid.”
Cuomo convened the Medicaid Redesign Team — the second of its kind since 2011 — to help bring down what he said is unsustainable spending on the program, which makes up 43 percent of next year’s multibillion-dollar budget hole.
Inside the meeting hall, state budget director Robert Mujica explained that while the state budgets for 3 percent growth in the program each year, a rate the administration considers sustainable, projected program growth is slated to hit 6.7 percent in the coming years unless changes are made.
New York previously brought its Medicaid spending down to “sustainable” growth levels following the 2011 formation of a Medicaid Redesign Team. From 2012 to 2018, the state’s share of Medicaid spending grew an average of 2.2 percent per year, compared to an average nationwide state-share spending growth of 5.3 percent, Mujica said.
But New York’s share has been on the rise once more, he said, driven by rising enrollment, a rising minimum wage, payments to financially distressed hospitals, and a boom in the long-term and personal care industries.
Munica’s presentation was disrupted roughly 10 minutes in by protesters who chanted and carried signs throughout the room. During the interruption, the state cut audio and visual to a livestream it was hosting on the Department of Health’s website for several minutes while protesters were escorted out.
During a separate presentation, state Medicaid Director Donna Frescatore identified long-term and personal-care services for the chronically ill and disabled as one of six areas where Medicaid may need to be “course corrected.”
Others include state payments to distressed hospitals, prescription drug costs, a rise in taxi livery and medical transportation use, health homes and care management for people with complex conditions and diseases, and “program integrity” — meaning abuse, waste and fraud.
She also outlined the process members of the public and stakeholders can follow if they’d like to submit savings and policy proposals to the MRT. The state has set up a new website where people can submit their ideas. They must be submitted by noon on Feb. 21, in order to be considered by the panel’s second meeting, scheduled for March 4 in New York City.
A date and location for the third meeting has not been scheduled yet, but Frescatore said it will be sometime in mid-March.
https://www.timesunion.com/news/article/Protest-disrupts-first-meeting-of-Cuomo-s-15048674.php