MRT II Implemented Budget Actions

One Medicaid Redesign Team II recommendation included in the SFY 2020-21 Enacted Budget was to create an option supported by the NY State of Health Marketplace that would allow individuals to more easily connect to private pay personal care services from LHCSAs.

More information on this initiative, the NY State of Health Private Pay Home Care Services Program Pilot, can be found below:

  • Reduce Mainstream Managed Care (MMC) Quality Pool Payments by 50%
  • Discontinue Value Based Payment (VBP) Stimulus
  • Discontinue the Hospital Enhanced Safety Net Program
  • Discontinue Delivery System Reform Incentive Program (DSRIP) Equity Pools
  • MLTC Rate Range Reduction
  • ATB Rate Reduction (1.0% Annually; Effective 1/1/20)
  • MMC Rate Range Reduction
  • Additional ATB Rate Reduction (0.5% Annually; Effective 4/1/20)
  • Shift Water Fluoridation funding to Capital
  • Coming Soon!
  • Reduce Indigent Care Pool for Voluntary Hospitals
  • Enhanced Safety Net Transition Collar Pool
  • Reduce Hospital Capital Rate Add-on (5%)
  • Coming Soon!
  • Coming Soon!
  • Reduce Workforce Retraining and Retention Funding by 25%
  • Integrated Grievances and Appeals for Duals
  • Marketing and Education for Dual Products
  • Moratorium on Managed Long-Term Care Partial Plan (MLTCP) Expansions
  • Managed Long-Term Care Partial Plan (MLTCP) Enrollment Cap Withhold
  • Change Auto Assign Rules Partial
  • CDPAP Reforms: Transportation Guidance on CDPAP PA to Medical Appointments
  • Offer Non-Medicaid Long-Term Care Programs to Encourage Delayed Enrollment in Medicaid "Private Pay Home Care"

July 23, 2020

On July 23, 2020, The Department of Health issued its invitation to New York State Licensed Home Care Services Agencies (LHCSAs) to participate in the "NY State of Health Private Pay Home Care Services Pilot Program" in the counties of Nassau, Suffolk, and Westchester in 2021.

This Invitation is part of New York State Department of Health´s implementation of the recommendation by the Medicaid Redesign Team II, which was included in the SFY 2020-21 Enacted Budget, to create an option supported by the NY State of Health Marketplace that would allow individuals to more easily connect to private pay personal care services from LHCSAs. The Private Pay Home Care Program aligns with the ease and accessibility of the Marketplace, providing consumers with a resource to review the home care aides that are available in their area and select private pay services that meet their needs; potentially avoiding comprehensive insurance programs such as Medicaid, which includes a personal services benefit. The invitation and related documents are listed below.

Additional questions about this Invitation may be directed to NYSOHHomeCare@health.ny.gov. Questions and Answers about this Invitation can be found here.

Downloads:

The invitation and related documents are listed below.

Questions and Answers about this Invitation can be found here.
Additional questions about this Invitation may be directed to NYSOHHomeCare@health.ny.gov.

  • Reduce Taxi/Livery Rates