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Current MRT Budget Proposals

The Department of Health (DOH) presented a webinar of the current Medicaid Redesign Team (MRT) budget proposals based on the 2015-16 Executive Budget. For the complete LeadingAge NY analysis of the Governor’s Executive Budget, please click here. To access a recording of the webinar and related materials, please go to the MRT website.

The webinar agenda included:

  • Global Cap Recap
  • Results through November 2014
  • Closeout Strategy
  • FY 2016 Global Cap Projections
  • MRT Phase V Recommendations

The $17 billion Fiscal Year (FY) 2015-16 global cap represents annual growth of $540 million, mostly in anticipation of growth in overall costs and enrollments, which are expected to grow by 400,000 over March of 2014. The 400,000 new enrollees include a projected 140,000 enrollees due to the Medicaid expansion under the federal Affordable Care Act (ACA), which are 100 percent federally funded. The budget also projects a cap of $17.7 billion in FY 2016-17, reflecting a growth of $779 million.

For the current FY, which ends on March 31, 2015, the State is running $10 million (0.9 percent) below estimates and expects to come in under the cap. This is positive news for providers who might otherwise incur rate cuts in order to come under the cap.

The MRT budget also includes provisions to enhance the collection of approximately $248 million in accounts receivable owed to the State from providers. Under this initiative, DOH is seeking to reduce all outstanding A/R liabilities by March 31, 2017, with providers being required to submit proposals to achieve full recovery over the next two years.

DOH is moving forward with the implementation of a Basic Health Plan (BHP) as provided for under the ACA to expand health care coverage for individuals with incomes between 138-200 percent of the federal poverty limits, but who are ineligible for Medicaid; this includes those ineligible due to immigration status. Federal matching dollars of 95 percent depend upon meeting relatively tight CMS mandated time frames. The administration has included language in its 2015-16 budget proposal to establish BHP rate setting authority. In the first phase of the BHP, approximately 250,000 Aliessa enrollees will be transitioned effective April 1, 2015.

The MRT budget also reflects the Executive Budget provisions that include Vital Access Provider program funding of $952 million for FY 2015 and $852 for FY 2016. Other MRT provisions discussed included the pharmacy initiatives and Hospital Quality and Essential/Rural Community Provider Investment as found in the proposed Executive Budget.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827