LeadingAge New York State Budget Review April 2017 | страница 3

State-Local Medicaid Cost Sharing
The Governor had proposed to reduce State Medicaid cost sharing to New York City by $50 million, which
would not have been implemented if the City entered into a joint savings allocation plan with DOH to increase
allowable federal claims for preschool and school supportive health by $100 million. The Legislature rejected
this proposal, which is not included in the final budget.
The final budget thus continues the State’s commitment to bear the full cost of any growth in non-federal
Medicaid expenditures and exempt local social services districts from sharing in the cost of any increases in
Medicaid spending.
Medicaid Trend Factors and Prior Year Cuts
The final SFY 2017-18 budget extends for two years the following prior period Medicaid cost containment
provisions that require periodic renewal:
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Trend Factor: Trend factor (inflationary) adjustments are eliminated through March 31, 2019 for all
Medicaid providers (except for pediatric nursing homes).
Other Cuts and Taxes: Previous cost containment measures including cash receipts assessments on
nursing homes and adult day health care (ADHC) programs; prior year trend factor reductions affecting
Medicaid providers and home care administrative and general cost caps are through March 31, 2019.
Vital Access Provider (VAP) Program
The final budget includes an appropriation of $132 million for the Vital Access Providers (VAP) program, as
well as a reappropriation of $212 million of existing VAP funds. The VAP program provides temporary rate
adjustments or lump sum payments to eligible providers to preserve access to services in areas experiencing
provider restructuring, reconfiguration and/or closure. VAP funds provide operational support, and are not
to support capital costs. Nursing homes and home care agencies are eligible to apply for VAP funding.
Workforce
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Minimum Wage: The 2016-17 State budget authorized phased-in increases to the State’s minimum wage.
The final 2017-18 budget includes $255.4 million in State funding, an increase of $211.4 million over
the 2016-17 levels, to support the direct cost of minimum wage increases for Medicaid-funded services
provided by home care agencies, nursing homes, Assisted Living Programs (ALPs), hospitals and other
providers.
Paid Family Leave: Last year’s final budget included a provision, commencing in January 2018, requiring
employers to provide employee-funded, paid leave for purposes of caring for a newborn child or a
seriously ill family member or other qualifying event. Under that legislation, the Superintendent of
Financial Services and the Chair of the Workers Compensation Board were empowered to determine
whether insurance coverage of this benefit would be subject to community rating or experience rating.
The Executive Budget had proposed to set up a fund to implement a risk-adjustment mechanism for the
benefit, which was not included in the final 2017-18 budget.
Workers’ Compensation Reforms: As part of the overall workers’ compensation reform included in
the final budget, the New York State Workers’ Compensation Board must establish a prescription drug
formulary by Dec. 31, 2017. The formulary must include a tiered list of medications that are pre-approved
to be prescribed and dispensed, as well as a list of non-preferred drugs that can be prescribed with prior
approval. The formulary will contemplate pharmacy reimbursement, a drug rebate program, a pre-
approval program, drug utilization review and limitations on the prescribing of compounded medications
and compounded topical preparations.
LeadingAge New York/April 2017
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