DOH Releases List of Delayed, Reduced or Cut Medicaid Budget Items

NYAPRS Note: In order to come up with sufficient savings and revenues to make up for a $1.1 billion loss in federal Medicaid funds connected with past OPWDD billing practices found excessive by CMS, the Cuomo Administration has released a plan that includes a number of items of particular interest to NYAPRS members, including

    • a $12.5m delay this year and next year in bringing up some Supportive Housing beds (doesn’t harm the previously committed $75m in supportive housing)
    • a $1.5 million delay this year and the next in implementing the Managed Long Term Care ombudsman program (seems to be a $1 million a year temporary reduction)
    1. a 2 year delay in allocating the $15 million Health Homes Infrastructure grant
    2. a $2.02 reduction (down from $10 million) in funding Health Homes Plus enhancements for at risk individuals
    3. $7.5m reduction during this year and the next in implementing the Integration of Behavioral Health and Physical Care Clinic services (down from $15 million a year)

Last week, the Cuomo Administration released 30-day budget amendments that described a variety of budget actions and delays Today, they released more details about how the $1.1 billion budget gap created by the federal decreases and state billing changes will affect the budget.

Here are some highlights for savings identified for the current budget year and the one to follow:

  • $200 million in Last Year’s Budget Savings To Pre-Pay 2013-4 Expenses
  • $24 million by Accelerating Medicaid Redesign Team initiatives ($70m in 2014-5) including (excerpts by NYAPRS):
    • $6.85m in Person Centered Medical Home savings ($3.43m next year)
    • $6.5m in Savings from Dual Medicaid/Medicare Demo (FIDA) ($27.5 m next year)
    • $3.25m by Accelerating Managed Long Term Care enrollment($1.25m next year)
    • $12m next year by Accelerating Behavioral Health savings (converting supportive housing, state inpatient state funds to capitated federally supported managed care payments)
  • $100 million in ‘Other Reforms’ ($114m in 2014-5) including (excerpts by NYAPRS)
    • $25m by managed care plan improvements in reducing inpatient, ER et al costs ($25m next yr)
    • $50m from working providers to reduce liabilities owed to the state ($50m next year)
  • $56 million by delaying 2013-14 MRT Investments ($56 million also in 2014-5) including:
    • $12.5m in delaying some Supportive Housing beds (another $12.5 million in 2013-14)
    • $1.5 million delay in implementing Managed Long Term Care ombudsman program (another $1.5 million delay next year)
    • $15m in delaying Health Homes Infrastructure grant (another $15 million next year too)
    • $2.02 delayed in funding Health Homes Plus enhancements for at risk individuals
    • $7.5m delayed in implementing the Integration of Behavioral Health and Physical Care Clinic services (another $7.5 million delayed next y ear too)
  • OPWDD Providers: 6% Across the Board Rate Reduction “or Other Alternative Savings”
    • $120 million this year and $120m next year
  • Additional Federal Revenue Investments $600m this year and $455m next year
    • Federal revenue from additional emergency Medicaid claiming and other possible efforts: $250 million this year; $85m next year
    • New waiver amendment to invest in comprehensive OPWDD reform in a manner modeled on MRT $250m this year and $250m next year
    • Additional FMAP savings produced by the Affordable Care Act (ACA) $120m this year and $477m next year
    • Restore 2% Across the Board reduction* ($20m this year and $357m next year); *Restoration begins in the fourth quarter of FY 2013-14

TOTAL RESOURCES TO SOLVE FEDERAL REVENUE PROBLEM $1.1 billion this year; $815m next year