Medicaid Fight Looms

Managed long-term care plans are pushing back at efforts by state lawmakers to redirect spending – setting up a potentially bruising battle in Albany when the six-month legislative session begins in January.

At issue is a proposal backed by the top Democrats on the Senate and Assembly health committees, as well as the powerful labor union 1199SEIU, to largely remove private insurers from the Medicaid long-term care business.

The move would change a provision of the state’s Medicaid redesign from a decade ago. And now a coalition of private insurers is banding together to preserve the current arrangement.

The New York State Coalition of Managed Long Term Care on Monday will launch its advocacy campaign. The groups, which include plans like Fidelis Care and Montefiore Diamond Care, will also unveil a website to highlight their opposition.

“The MLTC Coalition plans provide invaluable services to vulnerable New Yorkers and are committed to maintaining New York’s reputation as a national leader in caring for Medicaid enrollees who are older adults or have disabilities,” Emma DeVito, chair of the coalition and president/CEO of VillageCare, said in a statement to Playbook.

The coalition also wants to repeal the New York Independent Assessor Program, which it argues has added an additional layer of bureaucracy. And the plans want a policy of “sustainability funding” for managed long-term care and Medicaid Managed Care Quality Incentive Programs.

But key to their argument is a rejection of fee-for-service funding of long-term care, which the coalition has framed as a spending cut.

“Patient satisfaction and optimal health outcomes need to be driving the agenda in Albany, and we are committed to ensuring that care options for New Yorkers who are older or have disabilities are not disrupted by irresponsible reforms or budget cuts,” DeVito said.