ALBANY — The make-up of a blue ribbon panel poised to examine spiraling Medicaid costs is drawing strong concerns from some in the state’s health care industry.

Dr. Art Fougner, president of the Medical Society of the State of New York, a membership-backed lobby for physicians, told CNHI that it is “ridiculous” Gov. Andrew Cuomo’s 21-member Medicaid redesign team has no doctors without ties to the governor’s administration.

“They have everyone involved except the people who actually take care of the patients,” said Fougner, noting the panel also lacks representatives of the nursing profession.

Cuomo says his goal is to make Medicaid “financially sustainable.”

He plans to use the recommendations from the Medicaid team to fine-tune his $178 billion state fiscal blueprint before lawmakers vote on a new state budget. That vote is expected to take place in the final days of March, as the state fiscal year begins April 1.

The new appointments to the Medicaid panel include six state officials with close ties to Cuomo, including one physician, state Health Commissioner Howard Zucker, and representatives of several large health plan associations. The group will be co-chaired by Dennis Rivera, a former health care union executive, and the president of New York Presbyterian, Dr. Steven Corwin.

Also tapped for the panel was Suffolk County Executive Steven Bellone, one of Cuomo’s closest allies in county governments and the only county representative to join the group.

Cuomo, in a public radio interview Wednesday, noted New York’s Medicaid spending jumped about 7 percent in the past year. Medicaid programs are administered by county governments though the state has absorbed the costs.

“It is just improper administration of the program and that is what we have to tackle this year, and we are tackling it this year,” he said.

Among those voicing concern about the composition of the Medicaid team were the New York State Coalition for Children’s Behavioral Health and the Home Care Association. The latter group noted it serves some 900,000 New Yorkers with medical needs. Its providers, the group said, deliver “quantifiable savings made possible by home care interventions in chronic-care management.”

It remains unclear where the Medicaid team will look to come up with the $2.5 billion in savings targeted by Cuomo.

Noting some $5.2 billion is now collected through taxes and surcharges on health insurance, Health Plan Association President Eric Linzer said in a statement employers, consumers and unions already face high health care costs.

Bill Hammond, director of health policy research for the Empire State Center for Public Policy, said while Cuomo is in good position to “persuade” the Medicaid team appointees, “not everyone on the panel is going to be easy to manage.”

“The body is heavily weighted towards institutional providers” of health care services, Hammond said. He also said it is top-heavy with appointees representing downstate concerns and lacks a voice for consumers who pay the premiums and the taxes.

With some of the appointees representing institutions that derive revenue from the Medicaid system, Hammond said he is concerned the panel could end up recommending tax increases to fill the Medicaid gap.

A lawmaker who will help shape the budget negotiations for the GOP, Sen. Jim Seward, R-Milford, said he had hoped there would be more constituencies represented on the redesign team.

“County officials, ambulance providers, and upstate voices, among others, were left off by the governor, meaning key demographics will not be heard from during this crucial examination of our Medicaid system,” Seward said.

More than 6 million poor, disabled and low-income New Yorkers get their health care coverage from Medicaid.

Joe Mahoney covers the New York Statehouse for CNHI’s newspapers and websites. Reach him at jmahoney@cnhi.com



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As costs soar, state Medicaid program enters examining room – Lockport Union-Sun & Journal