On Friday, April 19, 2024, and Saturday, April 20, 2024, the New York Executive and the New York Legislature released and enacted the remaining Article VII budget language bills.  Many issues that were on the table did not make it into the budget, for example, the final budget does not include:

  • the proposed changes to the requirements regarding designated representatives/and the need to be self-directing for CDPAP/CDPAS (Consumer Directed Personal Care Assistance Program, also know as the Consumer Directed Personal Care Assistance Services) ;
  • elimination of wage parity;
  • repeal of the Medicaid Home Care Look Back (Medicaid to date has still not implemented this and there remains a push to repeal it);
  • repeal of the requirement for the need of three (3) Activities of Daily Living to qualify for home care services;
  • elder abuse/financial exploitation; or
  • the elimination of the asset test for over 65 and/or the disabled Medicaid eligibility

Items that did in fact make it into the budget and were signed into law included the following:

  1. For purposes of CDPAP/CDPAS, the transition to a statewide single fiscal intermediary (FI) by April 1, 2025; and together with that;
    1. mandates that Managed Care plans (MC), Managed Long Term Care (MLTC) plans, Social Service (SS) districts, and other programs offering CDPAP/CDPAS contracts with that single FI;
    2. That the statewide FI is to subcontract to an independent living center with at least one entity per rate setting region (expected to be four regional centers);
    3. cultural and language competency requirements; and
    4. establishes; criteria for selecting the statewide FI; prohibits the existence of any FI other than the statewide FI and its subcontractors, with all subcontractors registering with the Department of Health and giving the Commissioner the authority to issue orders to prevent inappropriate FI activity  (See, Part HH of the HMH Art. VII (S.8307-C/A.8807-C) of the Governor’s budget);
  2. Creates a new tax.  The Budget creates a new section of the Public Health Law requiring that the Commissioner of Health, in consultation with the Department of Budget (DOB), to apply for waivers from the broad-based and uniform regulatory requirements to establish a NY Managed Care Organization Provider Tax, in order to secure Federal Financial Participation (FFP) to support the Medicaid (MA) program.  The tax is to be placed on insurers, HMOs, MCOs, including Essential Plan, and coverage purchased on the Exchange.  Once implemented, revenues raised will be used for supplemental support to MA providers, among other things; (See, Part II of the HMH Art. VII (S.8307-C/A.8807-C) of the Governor’s budget).

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