In a battle going back 15 years, the federal Centers for Medicare and Medicaid Services (CMS) has pledged to reduce Medicaid reimbursements to New York for the state’s developmentally disabled centers by as much as 80 percent. Daily rates per patient at the facilities had jumped from just over $1,700 in 1999 to over $5,100 by 2011.

CMS, at the prompting of the House Oversight and Government Reform Committee, is also determining whether any past Medicaid reimbursements of as much as $15 billion made to New York can be legally recovered, despite the fact that they were federally approved.

At the same time, New York is pursuing three separate major Medicaid reforms with CMS that could be jeopardized by this troubling expose: a coordinated care for all waiver to move virtually every Medicaid recipient into managed care over the next three years, a People First Waiver to totally reform how care is provided for the developmentally disabled and a demonstration project to coordinate care for the costly “dual eligible” population that has both Medicare and Medicaid coverage.

With so many negotiating irons in the fire with CMS and an increasingly tight presidential and congressional elections, this could not come at a worse time for the State and its bold proposed Medicaid reforms, as the New York Times notes yesterday.

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