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Spectrum NY1: Bill introduced to expand transparency of Medicaid spending in New York

The need for homecare services is growing and recent Medicaid budget cuts are making it harder to meet this need. Valerie Bogart, Of Counsel for NYLAG’s Evelyn Frank Legal Resources Program (EFLRP), spoke with Spectrum NY1 about how the proposed legislation requiring the State to make Managed Long Term Care data public is a crucial first step. This transparency will help hold the state Health Department accountable for the money, resources, time, and services being allocated to homecare, ensuring that New Yorkers can remain in their homes. 

“Lawmakers ultimately want to change state law to eliminate Managed Long Term Care plans altogether and transition back to a fee-for-service model, but its passage is unlikely with less than a month left of session. May said increasing transparency of provider spending is a solid first step before the Legislature undertakes a significant system overhaul in the coming years. 

Valerie Bogart, counsel with the N.Y. Legal Assistance Group, noted the state pays each plan the same amount per member, but there’s a disparity in the type of care they receive depending on the plan. 

Bogart argues mandating the data reporting will ensure the state Health Department holds plans accountable and keeps more New Yorkers out of nursing homes — especially after a state comptroller’s report showing thousands of people are not getting the home care they’re supposed to be. 

“’And the state promised the comptroller, ‘OK, we’re going to track that better,’’ Bogart said. ‘Well, they haven’t. So this bill would say, ‘You have to do it. You have to have plans report. We can’t staff X number of cases for a week, for two weeks, for three weeks and let the plans be accountable for that. And they should be sanctioning plans that are not staffing cases.’ 

Bogart said plans have increasingly diverted high-needs patients into nursing homes and adult-care facilities in recent years, and consumers should be able to easily compare information about different plans.   

“’We live in a high-tech era. This is all possible to have all of this electronically.’ she said.” 

Read the full piece by Kate Lisa in Spectrum NY1 from May 16, 2024. 

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