Agenda 2005 | 2004 Legislative
Agenda | 2004 Priorities
State Budget and Related Information
following is a brief summary of highlights of the 2004-05 Executive
released on January 20, 2004:
of Long Term Care:
take-over of local Medicaid Long Term Care: to be phased in over
10 years. Take over is contingent upon enactment of cost containment
measures outlined in budget (i.e., closing eligibility loopholes;
increase revenues from non-state sources, etc.).
Closing eligibility loopholes (reform “spousal refusal”,
and look at tightening other eligibility rules).
Modify New York’s Partnership Program to offer more flexible
benefit package. Recommends State-funded reinsurance mechanism
to make long term care coverage more affordable. Embark upon public
education campaign to inform baby boomers about long term care
Authorize the Commissioner of Health to conduct demonstration
projects that promote the delivery of cost-effective and high
quality long term care services through the use of technology
and innovative approaches for service delivery.
Update Nursing Homes Rates – update the rate for labor costs
to reflect 2001 data.
Impose Financing Charge: re-established a 0.7 percent non-reimbursable
assessment on home care revenues and increase the assessment on
nursing home receipts from 5% to 6%.
Controlling drug costs – measures are designed to save Medicaid
program $93 million and EPIC $60 million.
Preferred Drug List (drugs such as anti-retrovirals, atypical
anti-psychotics, anti-depressants and anti-rejection drugs
would not be affected by PDP). Similar program for EPIC users
would go into place in 2006-2007.
Medicare Drug Care - provide EPIC participants incentives
to access Medicare Drug Discount Card. EPIC fees would be
waived for those low-income persons that quality for the annual
$600 discount care subsidy.
Proof Prescription Program – require use of non-reproducible
prescription forms for both controlled and non-controlled
Rationalize Pharmacy Costs – reduce pharmacy reimbursement
rates for brand name and generic drugs in both Medicaid and
EPIC programs – bring retail reimbursement rates more
in line with actual costs.
Increase co-payments for Medicaid participants - $.50 increase
for generic drugs; $1.00 increase for brand name drugs. Those
participating in managed care would be subject to same increases.
Care for State & Local Taxpayers:
Restructure Family Health Plus – require co-payments on
drugs, doctor visits and hospital stays, eliminate vision and
dental services; close eligibility loopholes.
Establish utilization and case management system for high-cost
Medicaid patients (drug abusers, mental and disability services).
Enroll dually eligible individuals in Medicare Part A
Dually eligible individuals on SSI will be encouraged to participate
in Medicaid Managed Care.
Eliminate podiatry services; services by private practicing dentists
and other practitioners including nurses, audiologists and psychologists
for adults on Medicaid.
Nutrition Assistance Program:
Funding maintained at $17.2 million.