Relates to long term care options for medicaid recipients; repealer

Showing the cosponsors who are on Agora, A to Z. The official record may list more.

• Democratic83
• Republican1

This bill has cosponsors from more than one party.

Shown in neutral colors by design; Agora is non-partisan.

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

New York State transitioned home care from a traditional fee-for-service model to a Medicaid managed care program or M LTC Plans in 2011, under direction from then Governor Andrew Cuomo's Medicaid Redesign Team. Under this model, New York State began paying for-profit insurance companies to manage and coordinate healthcare for several Medicaid services, in an attempt to improve care by coordinating between doctors and to save money by creating financial incentives to keep patients healthy and out of high-cost hospitals and nursing homes. The original intent was that MLTC plans would develop into fully capacitated plans over time. This has not happened. Instead, the majority of the services for-profit insurance companies currently provide are solely home care. Because of this "care coordi- nation" is limited, and the insurance companies administrative costs and profit are a drain on the Medicaid system. These resources could be reinvested to support the delivery of care through fee-for-service and fully capitated models ensuring more uniform care for residents of the state, as well as more adequate reimbursement to providers to support wage increases. This will help to assist providers in addressing health- care workforce challenges facing the state. In the past 3.75 years, New York State has given $5.9 billion to the 24 for-profit insurance companies managing home care in administrative costs and profit. In 2021 alone, the latest full year of data available, private insurance companies posted $722 million in profits, twice the national average. To address this, the "Home Care Savings & Reinvestment Act" would repeal the partially capitated MLTC program and instead provide appropriate long term care benefits under a fee - for-service model or through a fully capitated model where appropriate. This bill is estimated to generate significant annual savings, which can be used to reinvest and support the Medicaid program while addressing healthcare workforce issues. LEGISLATIVE LILA TORY: 2023-2024: S7800/A8470 Paulin

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.