LeadingAge New York State Budget Review April 2017 | Página 2

Overview
Final Budget for State Fiscal Year 2017-18
The final budget for State Fiscal Year (SFY) 2017-18, which is effective for the period April 1, 2017 through
March 31, 2018, was enacted into law on April 9, 2017. The $153.1 billion plan reflects the seventh
consecutive year of 2 percent or less growth in overall spending.
LeadingAge New York worked on several issues during the budget and was able to advance key objectives,
secure revisions to some budget proposals and successfully oppose other proposals that would have adversely
affected members, the people they serve and the services they provide.
The balance of this overview section summarizes areas of the budget that affect multiple long term care, post-
acute care and senior service lines.
Medicaid Global Spending
The final budget continues the Medicaid Global Spending Cap (“Global Cap”), including the State’s
“superpower” authority to make spending reductions if the Global Cap is breached, for one additional year,
through SFY 2018-19. The Global Cap represents an overall limitation on State Medicaid expenditures made
through the Department of Health (DOH), and limits growth in these expenditures to the ten-year rolling
average increase in the Medical Consumer Price Index (CPI). As a result, the global spending cap is increased
from $18.8 billion in SFY 2016-17 to $19.7B in SFY 2017-18, and $20.8B in SFY 2018-19.
Under the global cap, DOH and the Division of the Budget (DOB) continue to monitor monthly state
Medicaid spending. If spending is projected to exceed the global cap, DOH is authorized to take unilateral
action to reduce spending to remain within the cap. This authority is now extended through SFY 2018-19.
The final budget also authorizes DOB to unilaterally adjust the global cap to take into account any changes
made by the federal government to the availability of federal financial participation in Medicaid or any
reductions in the local share contribution.
Under the global cap shared savings program enacted in 2014, DOH and DOB will review Medicaid spending
prior to the start of each calendar year to determine whether actual spending is below the global cap
projection. If there are savings available for distribution, 50 percent or more is to be distributed proportionally
in the first quarter of the calendar year based on the claims and encounters submitted to Medicaid by each
provider and plan during the previous three-year period. The remaining savings, up to 50 percent, is to be
used to assist financially distressed and critically needed providers as determined by DOH. Based on currently
available information, there were no savings available for distribution during SFY 2016-17.
The final budget includes a separate cap on drugs within the overall Medicaid global cap. This cap is intended
to provide a focused and sustained effort to balance growth of drug expenditures with overall Medicaid
growth. The Medicaid drug cap will be based on the 10-year rolling average of the medical component of the
consumer price index plus a growth factor and reduced by a specified savings amount.
LeadingAge New York/April 2017
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