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Governor

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12/30/2011
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2011-12 Health/Medicaid, MMNY budget positions (as of 3/31/11)

This is a working document and it is subject to revision.



Governor Senate Assembly MMNY Enacted

MEDICAID MANAGED CARE

EXPANSION

Expand Medicaid managed Accept Accept Proposed language: Accepted, with requirement

care - exemptions for homeless, to consult with OCFS (from

kids in foster care, MMNY proposed language)

geographic proximity

- eliminate 60-day

treatment limit

- expand scope &

membership of MMCARP

Move pharmacy benefit Reject Accept, with modification Support Senate Accepted

into managed care to require MCOs to use the

PDL, CDRP, step therapy,

etc.

Expand services in Medicaid Accept Accept Oppose Accepted

managed care benefit

package to include personal

care

Mandatory Managed Long Accept Accept, with modification Oppose Accepted, but eliminates

Term Care enrollment cap on certificates

Managed Care Enrollment - Accept Accept Oppose Accepted

auto-assigned after 30 days

instead of 60 days

BENEFITS & ELIGIBILITY

REDUCTIONS

Eliminate carve-out for Accept Accept Oppose Accepted

currently exempt classes of

prescription drugs

Eliminate “prescriber Reject Accept Support Senate Rejected, for fee-for-service

prevails”

Eliminate Part D Medicaid Accept Reject Support Assembly Accepted

wrap for exempt classes





1

2011-12 Health/Medicaid, MMNY budget positions (as of 3/31/11)

This is a working document and it is subject to revision.



Governor Senate Assembly MMNY Enacted

Limit Level I personal care Accept Accept Oppose both houses Accepted

from 12 to 8 hours per

week; authorize COH to

adopt standards

Impose management and Accept Accept, with modification Support Assembly Accepted, with requirement

utilization in personal care to require standards to be that standards are issued in

for split-shift & other high- adopted by regulation, not regulation but allowing use

intensity cases to be done on emergency of emergency basis

basis

Limit PT, OT, and speech to Accept Accept, with modification Oppose both houses, but Accepted, without

20 visits per year; except to allow people with support Assembly as Assembly modification

DD and kids physical disabilities to get compromise

overrides (as with other

utilizations limits in statute)

Increase co-pays and Accept Reject Support Assembly Rejected

impose new co-pays;

increase co-pay annual cap

from $200 to $300

Eliminate spousal refusal Reject Reject, propose new Support Assembly Rejected completely

language

Limit opioids to 4 fills per 30 Accept, with technical Accept Support Assembly Accepted

days modifications

Enteral nutrition limits, w/ Accept Accept Oppose Accepted

medical necessity

Reduction of EPIC Reject Accept, with slight Advocates proposed MSP Accepted, but restores part

modification alternative that would of the premium assistance

extend MSP coverage to cut

EPIC enrollees; would also

expand access for people

with disabilities who are

under 65 who have

Medicare





2

2011-12 Health/Medicaid, MMNY budget positions (as of 3/31/11)

This is a working document and it is subject to revision.



Governor Senate Assembly MMNY Enacted

Orthopedic shoes and Accept Accept Oppose Accepted

orthotics - coverage limited

to growth and development

problems in children,

diabetics and when a shoe

is attached to a lower-limb

orthotic brace

Compression stockings - Accept Accept Oppose Accepted

limit to Medicare criteria

(treatment of open wounds

only) and during pregnancy;

no longer cover poor

circulation, varicose veins

and discomfort except In

pregnancy

TRANSPARENCY AND

ACCOUNTABILITY

Implement a global Accept, but require review Accept, provided a Oppose, support notice and Accepted, with modification

spending cap & consideration by the Medicaid savings allocation transparency requirements - DOB & DOH shall review

Legislature, 60 days notice, plan is made available to spending on monthly basis;

approval by Public Health the Legislature prior to DOH shall seek Legislative &

and Health Planning Council implementation stakeholder input in

developing allocation plan,

shall distribute to Finance

and Ways & Means 30 days

prior to implementing

N/A N/A N/A Increase from 10% to 100% N/A

the amount of hospital

charity care funding

allocated based on services

to the uninsured







3

2011-12 Health/Medicaid, MMNY budget positions (as of 3/31/11)

This is a working document and it is subject to revision.



Governor Senate Assembly MMNY Enacted

N/A Allow counties to N/A Oppose Rejected

determine which, if any,

optional services they will

offer in their Medicaid

programs

N/A N/A Propose new language to Support Accepted

require DOH to make

Medicaid waiver and plan

amendments public,

including drafts









4



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