NYAPRS Note: Don’t miss today’s noon final meeting of the MRT II where their final recommendations to find $2.5 billion in Medicaid savings will be discussed. See below for the call in information, the attached narrative and scorecard and yesterday’s summary from NYAPRS at https://www.nyaprs.org/e-news-bulletins/2020/3/18/nys-mrt-2-recommendations-include-1875-medicaid-cut. Here’re also a review taken in part from Crain’s Health Pulse and Politico.
The proposals add more than $1.6 billion in cost-cutting programs to the governor’s existing $851 million savings plan for fiscal 2021, which begins April 1. They include an additional $219 million across-the-board Medicaid payment reduction to health care providers, which, when added to the governor’s previously announced reduction, will result in a $467 million rate drop, according to a budget scorecard tallying the savings.
The panel also recommends increasing the 1 percent across-the-board reduction announced in late December to 1.875 percent in the next two fiscal years — a savings of $219 million in fiscal 2021 and $50 million in fiscal 2022.
The largest savings would come from a series of proposed changes to long-term care — a total of $648 million in fiscal 2021 and $1 billion in fiscal 2022 — according to the executive summary.
They include instituting a 60-month look-back period for home- and community-based eligibility; eliminating spousal and legally responsible relative refusal; and changing eligibility criteria for personal care services, the Consumer Directed Personal Assistance Program and enrollment in managed long-term care partial plans.
Some of the proposals regarding eligibility seem to violate the governor’s directive to the group to avoid any impact on beneficiaries.
“New York has always been proud that we have promoted care in the community. If you put all these barriers up people can’t stay in their homes,” said Valerie Bogart, director of the Evelyn Frank Legal Resources Program at the New York Legal Assistance Group. “There’s going to be a lot of nursing home placement.”
The redesign team noted that MLTC plan enrollment had been increasing 13% per year, with annual spending of about $1.3 billion
The MRT II, among other things, further recommends: reducing nursing home capital funding; delaying implementation of the expansion of Community First Choice Option services; and capping the statewide managed long-term care enrollment growth at a target percentage.
The MRT’s proposals for hospitals, meanwhile, would increase the progressivity of indigent care pool distributions, strengthen NYC Health + Hospitals and realize additional savings without impacting core hospital operations, for a total savings of $399 million in fiscal 2021 and $459 million in fiscal 2022, according to the executive summary.
The largest targeted cut is related to long-term care, which will see $674 million in payment reductions across home care and nursing home programs.
The redesign team said enhanced federal funding for Medicaid—which was included in an aid package to address Covid-19—should be used to mitigate the effects on health care providers. The federal funding bill complicates matters because states can only take advantage of the federal government paying a greater share of Medicaid costs if they offer the same eligibility standards they did on Jan. 1.
The savings initiatives include more stringent eligibility criteria to qualify for personal care and consumer-directed services, including an assessment by an independent clinician panel. Recipients would need to show they need assistance with more than two activities of daily living. The state also plans to reduce the number of fiscal intermediaries that process payments for caregivers.
Some of the proposals regarding eligibility seem to violate the governor’s directive to the group to avoid any impact on beneficiaries.
“New York has always been proud that we have promoted care in the community. If you put all these barriers up people can’t stay in their homes,” said Valerie Bogart, director of the Evelyn Frank Legal Resources Program at the New York Legal Assistance Group. “There’s going to be a lot of nursing home placement.”
It’s unclear whether the governor will accept the recommendations and whether they will pass muster with the Legislature. Hospitals are facing a surge in patients with Covid-19 and are expanding facilities and staffing to care for them. Enacting $2.5 billion in payment reductions would contradict the governor’s support for the industry. If he does offer respite for providers, the state will still need to grapple with a multibillion-dollar Medicaid deficit while projected tax revenues are expected to fall $4 billion below earlier estimates.
The Governor has said that language included in a federal coronavirus bill to prevent Medicaid changes, including proposed adjustments to the local Medicaid share paid by New York City and counties, would essentially prevent the state from passing a budget. It’s been said that he is working with Rep. Nita Lowey on changes to the Speaker Nancy Pelosi House language that will allow him flexibility to proceed with his Medicaid redesign.”
Event: Medicaid Redesign Team (MRT) II to Hold Member Meeting March 19, 2020
ALBANY, N.Y. (March 18, 2020) – The New York State Medicaid Redesign Team (MRT) II will meet on March 19, 2020, to collaborate on a final report to be submitted to Governor Cuomo for consideration in the State Fiscal Year 2021 Enacted Budget.
When: Thursday, March 19, 2020, 12:00 p.m.
Call-In Number: To listen to this meeting, please call: 1-855-897-5763 Conference ID#: 4067044
The New York State MRT webpage also offers more detail on the specific responsibilities and charges tasked to the MRT II, a complete list of MRT II members, and recorded webcasts of past meetings and public forums.