CHP: NYS OPWDD Overpayment Has Stalled CMS Action on MRT Waiver

Budget Battle Over The Disabled

Crain’s Health Pulse March 27, 2013

Gov. Andrew Cuomo's amended executive budget proposed $120 million in cuts to the Office for People With Developmental Disabilities providers. The plan set off heated debate among advocates for the disabled. But the Cuomo administration insisted a 6% cut in OPWDD Medicaid funding was a necessary result of negotiations with federal Medicaid officials regarding overpayments for the disabled. The budget restores $30 million to OPWDD providers of the $120 million in proposed cuts. The remainder of the governor's $1.1 billion contingency budget plan for OPWDD's lost revenue is included in the final budget as proposed, reports HANYS.

The unresolved issues with the federal government over the developmentally disabled have held up negotiations between the state and CMS on the terms of the state's $10 billion MRT waiver request (NYAPRS: for more see http://www.nyaprs.org/e-news-bulletins/2012/201264CuomoFed.cfm).

GNYHA noted that the health care industry has kept spending under the Medicaid global cap, ending this fiscal year about $200 million below the cap. That money will be critical for offsetting the loss of federal dollars in the state's new fiscal year for services provided to the developmentally disabled. "The $200 million in savings," said GNHYA, spares "members from further reimbursement rate reductions."

The budget reflects consensus on a number of state reforms affecting the developmentally disabled population and how it can be included in managed-care initiatives. This includes the OPWDD Fully Integrated Duals Advantage program, or FIDA, and a pilot for Developmental Disability Individual Support and Care Coordination Organizations, or DISCOs