LeadingAge New York State Budget Review April 2017 | Page 25

Summary of NYS Budget by Functional Area

EXECUTIVE BUDGET
FINAL BUDGET
PROGRAM FUNDING
VAP Program
Includes appropriation of $132 million for VAP, as well as a
re-appropriation of $212 million of existing VAP funds.
Includes Executive proposal.
PROVIDER/PLAN REIMBURSEMENT
DOH commits to explore separate rate cells or risk
adjustment for nursing home, high cost/high need home
and personal care, and HARP (side letter).
Discrete Cells in Managed Care Rate-Setting
No provision.
Managed Care Rate Transparency
DOH commits to provide quarterly updates to the legislature
on Medicaid Managed Care rates (side letter).
No provision.
Nursing Home Bed Hold Benefits
• Eliminates bed hold payments to all nursing home
providers while preserving the requirement for nursing
homes to hold beds for residents who temporarily leave
the nursing home.
• Requires that an across-the-board reduction for all nursing
homes other than pediatric facilities be made to achieve
an annual savings of $18 million. This would replace the
existing bed hold-related, $18 million across-the-board cut
currently reflected in nursing home Medicaid rates.
Nursing Home Benchmark Rate
•
•
For Medicaid beneficiaries aged 21+, eliminates
hospitalization bed hold payments entirely, while
maintaining 10 days of therapeutic leave per 12-month
period reimbursable at 95% of the Medicaid rate.
Makes permanent the bed hold-related cut already
reflected in current Medicaid rates that results in $18
million in annual savings.
Requires Medicaid managed care plans to pay the nursing
home benchmark rate until Dec. 31, 2020.
No provision.
Reduction of MLTC Quality Payment
Reduces annual MLTC quality pool by $30 million. No language enacted to prevent administrative action.
Transportation Carve-out
Eliminates transportation from the MLTC benefit package
and adjusts plan premiums accordingly. Manages the
transportation of MLTC members and ADHC program
participants through the State’s transportation managers. Does not include Executive proposal.
PROGRAMMATIC INITIATIVES
Administrative Hearing Office Consolidation
Creates a new Division of Central Administrative Hearings
led by a Chief Administrative Law Judge (ALJ), to be
appointed by the Governor.
Authorization for Fiscal Intermediaries
No provision.
Consolidation of Public Health Programs
Consolidates 39 public health appropriations into four pools:
(1) disease prevention and control programs; (2) maternal
and child health programs; (3) health workforce programs;
and (4) health outcomes and advocacy programs. Reduces
funding for each pool by 20%.
LeadingAge New York/April 2017
Does not include Executive proposal.
Requires CDPAS fiscal intermediaries to apply and receive
authorization to operate from DOH.
Does not include Executive consolidation proposal, but
accepts the 20% reduction in funding to the programs. The
39 programs include both the Nursing Home Transition and
Diversion and Enriched Housing programs.
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