The ball in Times Square isn’t the only thing dropping on New Year’s Eve: The state Health Department also announced a 1 percent reduction in most Medicaid payments.

It’s the Cuomo administration’s first public step toward closing a mushrooming deficit in the safety-net health plan that covers more than 6 million New Yorkers.

The rate cut, which takes effect Jan. 1, was published in the Dec. 31 edition of the New York State Register.

The notice said the move will reduce gross Medicaid payments, including federal matching aid, by $124 million in the final quarter of the current fiscal year and $496 million in the fiscal year beginning April 1. The state’s share of the savings was not specified, but it would likely be about half of that amount – or $62 million this year and $248 million next year.

That’s about 3 percent of the amount Cuomo has said he intends to cut before the end of March.

Officials say the state faces a $4 billion deficit in fiscal year 2019-20, which they intend to close by cutting $1.8 billion in spending and pushing $2.2 billion in expenses into future fiscal years. The state also faces a projected gap of $6.1 billion for 2020-21.

It should be emphasized that these cost-cutting moves are about slowing growth. Even if they are fully implemented, overall spending on Medicaid will almost certainly increase in the year ahead.

The rate cut applies to the vast majority of Medicaid spending, including payments to hospitals, nursing homes, doctors, pharmacists, home-care providers and Medicaid managed-care plans.

The cut will not affect certain programs and providers that are paid entirely with federal funds or otherwise exempt by federal law – the largest example being Medicaid-funded services provided through the Office of Mental Health and the Office for Persons with Developmental Disabilities.

These providers, in fact, are due to receive a funding increase meant to boost the wages and benefits of caregivers by 2 percent, which was a provision of the state budget approved in March. That rate hike, also announced on Tuesday, is expected to increase gross Medicaid spending by $140 million.

In a third notice published Tuesday, the Health Department also revived its proposed changes to the rapidly growing Consumer-Directed Personal Assistance Program, which allows qualifying individuals with disabilities to employ their friends and family members as in-home caregivers.

The changes affect reimbursement for the “fiscal intermediaries” that handle paycheck processing, tax deductions and other financial services on behalf of consumers in the program. Officials are proposing to pay them a fixed monthly fee per client instead of a percentage-based fee, a change it has said would save the state $75 million a year.

In October, a judge blocked a similar plan on grounds that the state had not followed the proper rule-making procedures – the process it has now launched with Tuesday’s announcement.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

Is Hochul Really Going to Shut Down the Essential Plan?

Governor Hochul is hingeing a big chunk of her budget – and the state's health-care system – on a politically fraught gambit: asking the Trump administration to help cover immigrants. Read More

State Delays Disclosing Emails About $1B Home Health Contract

For a third time the state Health Department has postponed releasing records related to a disputed $1 billion Medicaid contract, saying it needs another six weeks or more to locate and redact the materials in question. Read More

Email Confirms Early Contact Between NY Officials and CDPAP Contractor

State officials met with the ultimate winner of a $1 billion Medicaid contract two weeks before the Legislature authorized bidding on the job as part of the state's 2024-25 budget, an email obtained by the Empire Center sho Read More

Budget Update Paints Less Alarming Picture of Federal Health Cuts

A new fiscal report from the state Budget Division suggests federal funding cuts will hit New York's health-care budget less severely than officials have previously warned. A relea Read More

DOH Ducks a Simple Question on Covid in Nursing Homes

Five years after the coronavirus pandemic, the state Department of Health is pleading ignorance about one of its most hotly debated policy choices of the crisis – a directive that sent thousands of infected patients into Read More

In the Fight Over ACA Tax Credits, the Stakes Are Lowest for New York

As Washington skirmishes over the future of enhanced tax credits under the Affordable Care Act, New York has relatively little to gain or lose. The number of New Yorkers using any A Read More

New York’s Immigrant Health Coverage Becomes a National Flash Point

A little-noticed New York program that provides Medicaid coverage to elderly undocumented immigrants was thrust onto the national stage this week as the White House sparred with congressional Democrats over the federal gove Read More

Why New York’s Health Premiums Keep Going Up

New Yorkers continue to face some of the costliest health premiums in the U.S., and the insurance industry's recently finalized rate applications shed light on why that is. In summa Read More