The New York Medicaid program led the way in the last few years in implementing changes related to the Affordable Care and Patient Protection Act (Obamacare) signed into federal law by the President. The law is complex, but one key piece is an optional expansion of Medicaid benefits to state residents. The manner in which the state leaders have chosen to implement the changes is of crucial importance to all New York residents who rely on the program for day-to-day support--including seniors.
The expansion of the program via the federal law has coincided with internal efforts seeking to more efficiently use state resources to root out fraud and waste. The state's Medicaid Redesign Team has worked over the last few years to modify rules, crackdown on abuse, and otherwise ensure the billions spent each year are being put to good use.
Recently, those two missions ran into a bit of a snag, as New York officials challenged federal administrators over the state's attempt to receive an exemption from certain federal rules in order to implement its own Medicaid efficiency improvement plan.
The main disagreement stems from the state's attempt to reinvest an alleged $10 billion in savings to help hospitals in dire financial straits which cater to low income individuals as well as invest in the Home Health project. As discussed today in the Washington Post, the Department of Health and Human Services (HHS) has yet to approve the use of the projected savings. Some state officials are angered by the federal officials "dragging their feet."
State officials claim that the New York City public hospital system is struggling financially specifically because of federal cuts related to reimbursement for treating low-income patients included as part of Obamacare. Considering that the budget problem stemmed from Obamacare changes, the state is confused as to why the exemption has yet to be processed in order to offset the problem. Some officials have gone so far as to suggest that Governor Cuomo implied he may pull out from the Medicaid expansion altogether if the exemption request is denied.
The exemption was first requested over a year ago, and recently federal officials asked for even more information from state officials--further delaying the resolution. All of this has led many of New York's Congressional delegation to voice anger at the way HHS has handled the matter.
However this specific conflict gets decided, it is critical for local families who may need Medicaid support in the future for nursing home stays to contact elder law professionals for guidance and counsel.