Medicaid Redesign Team’s Final Recommendations

The final meeting of the full Medicaid Redesign Team (MRT) was held today in Albany.  In addition to a webcast, other meeting materials can be found here.  The general purpose of today’s meeting was to accept the reports from the remaining work groups and outline the process for the transmittal of the final MRT recommendations to Governor Cuomo.

The meeting began with an update from State Medicaid Director Jason Helgerson on the status of Medicaid spending in relation to the global spending cap.  Helgerson reported that Medicaid spending through the end of October squeaked in under the projected spending amount.  Estimated spending had been at $9,265,558 but the actual spending was at $9,140,844-a difference of $124,714. Although spending was less than anticipated, Helgerson noted that the Department continues to closely watch the Medicaid enrollment numbers. Since April there has been a 2% increase in Medicaid enrollment and a 2.7% increase in Medicaid Managed Care enrollment. While the Department is monitoring the enrollment numbers Helgerson did note that the antiquated eligibility system in New York could be skewing the enrollment numbers.  The formal report on Medicaid spending should be available on the Department’s website today.

The focus of the meeting then shifted to an overview of the process by which the MRT would share its recommendations with Governor Cuomo.  It was reported that Department of Health staff have prepared a report that will be shared with the MRT members for review and feedback. This report will include a summary of Phase 1 MRT reforms and the approved recommendations of the MRT work groups. This report will be sent to the MRT membership on December 14th with the understanding that any feedback from MRT members must be received by December 20th. The final report will be sent to Governor Cuomo on December 31st.

Prior to the sharing of the work group reports there was a brief discussion among MRT members as to whether the workgroups would continue meeting after the report was sent to the Governor. There is no formal process in place by which the work groups will continue to meet.  All parties agreed that this issue warrants further discussion.

The presentations of the four work groups were largely uneventful.  Co-chairs for each work group gave presentations on their respective work group’s activities and final recommendations.  The Basic Benefit Review work group presented first, followed by the Workforce Flexibility and Scope of Practice work group, the Payment Reform and Quality Measurement work group and the Affordable Housing work group.  For the most part the recommendations of the work groups were accepted by MRT members with little controversy.  However, there was a lively discussion regarding recommendations contained in the Basic Benefit Review work group’s presentation. The work group had proposed creating an evidence based system to review whether a benefit should be covered under Medicaid. Both Assembly member Gottfried and Senator Hannon expressed reservations about this concept.  Ultimately it was agreed that the recommendation should reflect that any meetings regarding changing Medicaid benefits be open to the public and that the Legislature’s role in changing Medicaid benefits must be preserved.

Another notable exception to the approval of recommendations was Assemblyman Gottfried’s decision to abstain from voting on the Workforce Flexibility and Scope of Practice work group recommendations.  Gottfried explained that the Assembly’s chair of the Higher Education Committee Deborah Glick had reservations about some of the proposals and that in deference to those concerns he would not be voting for the package.  Additionally, a large number of people from the labor union DC 37 were in attendance to protest some of the MRT Phase I proposals relating to rolling certain benefits and populations into Medicaid Managed Care.  In a departure from the MRT’s normal practice, Co-Chair Michael Dowling gave the group’s representatives a five minute time slot to speak to the larger group.

Before the close of the meeting, MRT member Stephen Berger made a motion that a recommendation in support of increased staffing for the Department of Health be included in the report to Governor Cuomo. The group agreed that increased staffing was critical to the success of many of the MRT initiatives.

-Jaime Venditti, 12/14/11