Tag budget

Huffington Post: New York State Will Cover Breast Milk Donations For Preemies From Low-Income Families

By Caroline Bologna, 4/24/17

New York recently became the latest state to cover breast milk donations for babies from low-income families.

On April 9, the New York State Legislature approved the 2017-18 state budget, which includes a provision granting Medicaid coverage for donor breast milk to premature babies in the NICU. The measure received bipartisan support.

“We are putting our babies first and our legislators understand that,” executive director of the New York Milk Bank, Julie Bouchet-Horwitz, told The Huffington Post. Bouchet-Horwitz noted that “all babies, regardless of the economic status of their parents,” deserve access to pasteurized donor human milk (PDHM) when their own mothers’ milk is not available or sufficient.

Budget Update: Medicaid Long-Term Care

It has been becoming increasingly difficult for Medicaid patients needing long-term care – especially home care for extended hours – to get the care they need.  In many areas, there is a shortage of home care aides because low reimbursement rates make recruitment and retention of workers difficult.  State payment rates to managed care plans discourage them from serving high-need patients properly.  The methodology for assessing patient need does not adequately account for cognitive deficiency and other factors.

The newly-enacted state budget legislation (A.3007-B) includes several important actions intended to begin to turn around this siutation.  In addition, the Department of Health (DOH) sent a side letter to the legislature committing to several further actions (indicated below as “Administrative action, side letter”).

  • Consumer Directed Personal Assistance Program (CDPAP) fiscal intermediary authorization: Requires fiscal intermediaries in the CDPAP program to register with DOH (“authorization”), and defines their scope of services.  In 2015, similar legislation was vetoed and this year’s legislation comes from negotiation among the Assembly and Senate Health Committees, DOH, and the fiscal intermediaries.
  • CDPAP wage parity: Adds workers in the CDPAP program to the Medicaid wage parity law that currently applies to other home care workers, primarily in the downstate metropolitan region.  It will phase in to reach full parity in three years. Medicaid payments to managed care plans will cover this, and managed care plans will attest to the wage pass-through in cost reports.
  • Uniform assessment system (UAS):  
  • Adds “cognitive” to the current evaluation of patient “medical, social and environmental needs” required for managed care enrollees. Because of a drafting error, this provision is found in the “revenue” budget bill (A.3009-C, Part GGG) rather than in the “health” budget bill (A.3007-B).
  • DOH will hold regular meetings with legislators, stakeholders, and the UAS program team in order to examine and formulate improvements to the UAS. (Administrative action, see side-letter)
  • High-need rate cells or risk adjustments for managed long term care: (Administrative action, see side-letter.) DOH will work with legislators,  advocates, providers, and managed care organizations to evaluate separate rate cells or risk adjustments for the nursing home, high-cost/high-need home and personal care, and Health and Recovery Plan (HARP) populations.  Resulting adjustments will require approval by the federal Centers for Medicare and Medicaid Services.
  • Delaying TBI/NHTD carve-in to managed care: (Administrative action, see side-letter.) DOH will further delay the carve-in of the Traumatic Brain Injury and Nursing Home Transition and Diversion waivers into managed care from April 1, 2018 to January 1, 2019.
  • Nursing home bed-hold: The legislature restored the bed-hold payments for therapeutic leaves of absence at a 95% payment rate for up to 14 days annually.
  • Nursing home benchmark rates: The transitional “benchmark” Medicaid payment rate for nursing homes patients moving from fee-for-service to managed care will be extended until 2020.
  • Managed Long-Term Care (MLTC) and Adult Day Health Care (ADHC) transportation: (Administrative action, see side-letter.) DOH will not carve-out the Medicaid transportation benefit from MLTC or ADHC programs for the 2017-2018 fiscal year.
  • Spousal and family support: The Legislature protected the resources of family members by rejecting the Governor’s proposal to require them to pay for an individual’s long-term care before the individual could become Medicaid eligible. This was the 28th consecutive year that this has been proposed by five governors and rejected by the Legislature.

Albany Times-Union – Lawmakers call to fund donor breast milk for premature babies

By Rick Karlin, 3/27/17

As they have with several measures that have bubbled up in recent weeks, lawmakers are reviving a bill that was vetoed by Gov. Andrew Cuomo last year with instructions that it should be a part of the budget package.

Both GOP Sen. Kemp Hannon and Democratic Assemblyman Richard Gottfried, who head their respective health committees, on Monday urged passage of a measure that would allow Medicaid to cover the cost of donated breast milk, which they said can be a life-saving nutrient to premature infants who develop necrotizing enterocolitis, a serious intestinal ailment that can hit such babies.

Gannett – Repeal of Obamacare could bust New York’s budget

By Joe Spector, 11/11 (via WGRZ)

ALBANY — President-elect Donald Trump’s pledge to repeal and replace the Affordable Care Act could have steep fiscal implications for New York, which has 3.3 million people enrolled in its health exchange.

Since New York’s health exchange launched under so-called Obamacare in 2013, Medicaid recipients rapidly increased as millions of low-income New Yorkers signed up for health care.

The federal government subsidized much of the cost, and last year New York launched a new program, the Essential Plan — an off-shoot of Medicaid that in part provides coverage to immigrants otherwise ineligible — that has seen its enrollment soar.

The state Budget Division estimated that the federal subsidies for the Essential Plan alone this year would exceed $1 billion, which could be wiped out under Trump’s proposals.

Times-Union – End of Obamacare Could Cost New York $850M

By Claire Hughes, 11/10

President-elect Donald Trump‘s intention to repeal and replace the federal Affordable Care Act could affect New York’s budget, to the tune of at least $850 million a year.

Billions more are at stake if a Trump administration and Republican-led Congress stop funding the expansion of Medicaid under the 2010 law, the signature health policy of President Barack Obama known as Obamacare.

Other Republican reforms could impact what New Yorkers pay for health insurance, whether they are individuals buying policies on the state’s Obamacare website, NY State of Health, or workers who get coverage through their employers.

A full repeal of the law may not be that easy, at least under current congressional rules, but changes that affect the federal budget could be made through the reconciliation process. Republicans have already tried to alter the law through that method, but have had their bills vetoed by President Obama. President-elect Trump would likely sign off on such measures, said Richard Nathan, who directs the ACA Implementation Research Network at the Rockefeller Institute of Governmentin Albany.

At a minimum, the state would lose a large portion of the estimated $850 million in federal assistance for offering what in New York is called the Essential Plan, according to state Assembly Health Committee Chair Richard Gottfried, D-Manhattan. The Essential Plan offers health coverage with no deductible for $20 a month to low income New Yorkers who do not qualify for Medicaid.

WNYT-TV: Brain Injury Patients Rally to Keep Vital Care

See the video here: WNYT News Channel 13

ALBANY – For the first time in its history, the Brain Injury Association of New York rallied at the State Capitol.

The gathering on Wednesday was a final push to convince lawmakers about the need to fund the specialized treatment this group argues, is so vital to their independence and recovery.

The fact that Laura Casellini is here to celebrate her 24th birthday is a milestone that wasn’t assured.

Five years ago the car she was riding in was slammed into by a drunk driver.

Still recovering from a traumatic brain injury, the East Greenbush woman credits the intensive and coordinated services she receives for her recovery.

“I have had a very good recovery,” she noted.

When asked if it would have been as good without the care, she replied, “It would not have been as good. I would have been stuck in a nursing home.”

In New York, services for brain injury patients like Casellini are provided through special waivers. It’s a system of payment and care the governor’s office wants to do away with, transitioning this population to managed care.

“140,000 New Yorkers and of them, 3,000 of them are on traumatic brain injury, TBI waiver,” explained Eileen Reardon, the executive director of the Brain Injury Association of New York State.

Fear about losing services and careful coordination of those services brought the Brain Injury Association of New York State, BIANYS, to the state Capitol for its first ever “Advocacy Day.”

They want to be sure their voices are heard in advance of the April 1 deadline for the state Health Department to release its transition plan.

They’re counting on support from leaders in the state Senate and Assembly.

“However the program is structured, whether it stays outside managed care or moves into it, that the unique, important elements of the TBI waiver are guaranteed in law and protected against tampering,” noted Democratic Assem. Richard Gottfried the Health Committee Chair.

Money to continue the services has been recommended by both the Assembly and Senate Health Committees.

However, anything can happen between now and when the governor presents his budget.

It’s still to be seen what the transition plan looks like when it’s released April 1.

NewsChannel 13’s Benita Zahn will keep you posted.

Politico: Cuomo, de Blasio have small window to find savings in Medicaid

By Dan Goldberg and Josefa Velasquez, January 21

Gov. Andrew Cuomo and Mayor Bill de Blasio have less than 10 weeks to find $180 million in Medicaid savings if they are to keep a pledge to find efficiencies in the program before the state budget is enacted. The new fiscal year begins on April 1.

The sudden sprint is the result of Cuomo’s proposal to lift the cap on New York City’s Medicaid share, a move that would cost the city nearly $2 billion over the next four years if it were to take effect.

Cuomo said his own proposal won’t be necessary because “there are no two people better equipped to work through tough issues than the mayor and myself.”

De Blasio, eager to avoid potentially devastating cuts, agreed to find the efficiencies and savings sought by Cuomo, whose original rationale for lifting the city’s cap did not mention efficiencies or administrative savings.

Video – Health Care Interview on Manhattan Public Access

I sat down with Mark Hannay, Director of the Metro New York Health Care for All Campaign, to discuss the health budget, Medicaid reform, and single payer healthcare:

NY Post: Legislature Kills Cuomo’s Proposed Tax on Obamacare

By Carl Campanile, 3/31/15

The state Legislature has killed a $69 million tax on health-insurance policies proposed by Gov. Cuomo to pay for the administrative costs of continuing New York’s ObamaCare exchange, The Post has learned.

Cuomo’s office initially said the levy — which would have cost about $25 per policy — was needed to make up for federal funds no longer available to cover operating expenses of the New York Health Exchange under the Affordable Care Act.

But lawmakers balked, arguing the new tax was counterintuitive to the goal of making health insurance more affordable.

Budget Season Photos

Photos credit – Assembly Photography

Opening remarks at VOCAL's HIV/AIDS Legislative Advocacy Day, with Senator Gustavo Rivera.

Opening remarks at VOCAL’s HIV/AIDS Legislative Advocacy Day, with Senator Gustavo Rivera.

Joint Conference Committee on Health meets on the budget

Joint Conference Committee on Health meets on the budget

More from the Joint Conference Committee, with Sen. Hannon (L), A/M Cahill (R), and A/M Raia (standing)

More from the Joint Conference Committee, with Sen. Hannon (L), A/M Cahill (R), and A/M Raia (standing)

Packing the stairs for the Share Better Coalition's rally against illegal hotels

Packing the stairs for the Share Better Coalition’s rally against illegal hotels

Speaker Heastie leads press conference before Assembly passage of Reproductive Health Act

Speaker Heastie leads press conference before Assembly passage of Reproductive Health Act

More budget conversations with Assembly Members Barron (L) and Titone (R)

Discussion with Assembly Members Barron (L) and Titone (R)

Speaking on the budget

Speaking on the budget