2014 Policy and Budget Agenda
Medicaid Managed Care
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Comments on the Delivery System Reform Incentive Payment Program
As New York State begins to transform the entire delivery system through Medicaid Redesign, Medicaid Matters New York (MMNY) looks at the Delivery System Reform Incentive Payment (DSRIP) program in terms of how real people will interface with a newly-transformed system, how the providers and community-based organizations that serve them will continue to do their work, and how the Medicaid program will continue to meet the needs of everyone it is intended to serve.
MMNY submitted comments regarding key areas of interest and concern to Attachments I and J, as they are intended to govern the implementation of Performing Provider Systems (PPS) and the DSRIP projects, along with the Special Terms and Conditions agreed upon by the Department of Health and the Centers for Medicare and Medicaid Services (CMS)
The comments are available here.
April 2, 2014
Consumer advocates applaud Health Budget agreement,
thank Governor and legislators for their leadership
Medicaid Matters New York (MMNY), the state’s Medicaid consumer advocacy coalition of over 140 organizations statewide, is pleased with the final outcome of the 2014-2015 Health/Medicaid budget. It includes many provisions MMNY advocated for that will improve the lives of New Yorkers served by the Medicaid program.
The final budget included the following provisions which were among MMNY’s priorities this year:
- Aid continuing – People in mainstream managed care and managed long term care will have the right to have their aid continue while they go through the fair hearing process if their plan decreases or eliminates their services at the end of an authorization period. This is particularly critical for people receiving long term services in their homes who would be at risk of nursing facility placement or hospitalization if their services are unduly cut.
- Basic Health Program – Authorizes the creation of a new health insurance product to provide affordable, quality coverage for people just above Medicaid income eligibility, reducing the churn in and out of coverage, and allowing the state to receive funding for covering legal immigrants who are currently covered with state dollars.
- Managed care advocacy services – The budget continues funding for implementation of an ombudsperson program, which when up and running, will provide individual, independent assistance and advocacy services for people new to Medicaid managed care enrollment, beginning with managed long term care.
Medicaid consumer advocates thank the Governor, Legislative leaders, committee chairs and their staff for achieving these accomplishments.
While we are very pleased with the overall health budget, we are disappointed with the failure to include full implementation of the Community First Choice (CFC) Option in this year’s budget, which would have been a sweeping, historic change to the way long term services and supports are provided in New York. We are encouraged by the conceptual agreement reached at the end of the budget process, and we look forward to seeing the CFC achieved before the end of the legislative session.