Governor releases 30 day amendments

Gov. Cuomo released his 30 day amendments, which generate $500 million in health care savings, including $180 million from accelerating Medicaid Redesign Team initiatives and delaying investments; leveraging $200 million in current-year under spending to generate 2013-14 savings; and $120 million from a 6 percent reduction to OPWDD Medicaid rates for not-for-profit providers. There is a lot of discretion left to the Commissioner of Health and the Division of the Budget, in consultation with provider organizations, to find savings under the Medicaid cap. The amendments of concern to LeadingAge New York members include:

• a reduction to OPWDD rates of reimbursement – a 6 percent across-the-board cut to not-for-profit providers providing Medicaid eligible residential and nonresidential services and support due to a reduction in Federal aid of $1.1 billion. This amendment effectively rescinds the 6 percent in rate increases/healthcare enhancements OPWDD providers have received since 2008-09;


• removes language limiting the expansion of Assisted Living Program (ALP) beds to New York City;


• clarifies technical pieces related to scope of practice for home health aides including: only an agency or program that is approved by SED may participate in the demonstration program and not all tasks within the scope of nursing are assignable to an advanced home health aide;


• adds language to allow the Commissioner of Health, in consultation with the Director of the Budget, to annul implementation of two percent across-the-board Medicaid reimbursement reductions; and


• adds language to delay investments in regard to allowing certified social workers to bill Medicaid; establishing health home infrastructure governance support grants; and rate increases for the integration of mental health, substance abuse and physical health services in a single location.

The good news here is that there are not any hard cuts to providers and there is the potential for the removal of the 2% across-the-board cut. LeadingAge New York will take part in the Medicaid Global Cap Workgroup meeting this afternoon and get a more thorough briefing on these changes and the department’s plans for managing these cuts under the cap.