Spotlight: Sneaky Budget Provision Jeopardizes New York's Managed Medicaid Patients

FOR IMMEDIATE RELEASE
February 27, 2024
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WASHINGTON — As state lawmakers return to Albany this week after the holiday recess, Gov. Kathy Hochul's $1.2 billion in proposed Medicaid cuts continues to be a hot topic. However, there is a small provision related to Managed Medicaid patients in the governor's budget proposal that has been flying under the radar. And it will have devastating consequences if enacted.

This provision is found in Part H of the Executive Budget Health & Mental Hygiene Article 7 legislation. It would eliminate the ability of medical providers to bring a claim to the state's independent dispute resolution (IDR) process -- the nation's first -- for various public health insurance plans. The proposal also claims this will save the state a paltry $7.5 million on a budget of $233 billion, yet no one knows how those savings have been calculated.

If legislators put this provision into the final state budget, then 5 million Managed Medicaid beneficiaries will lose access to essential on-call emergency department care and immediate surgical care in hospitals across the state.

According to Christopher Sheeron, president of Action for Health and the State Care Network:

"This Managed Medicaid provision affecting the state's IDR process will cut the healthcare benefits from the people who need them the most. Given that leaders in Albany have been rightfully emphasizing the importance of health equity and justice, we are shocked to even see this in the executive budget. This seemingly minor provision would create a two-tiered health system in the state.

"As Members of the Assembly and Senate continue working on their one-house bills, it's essential that they don't jeopardize the access of single mothers, seniors, and others on Managed Medicaid plans to the services and treatment they need.

"Additionally, the Department of Financial Services tried to sneak in this provision administratively before. They were caught red-handed and failed. Now, this provision in the budget is simply another power grab by the health plans. No one else benefits from this. The plans will pocket the alleged savings, and the state will not see any of the money. Simply put, now is certainly not the time to slash health benefits for the state's most vulnerable citizens."

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