Legislative Agenda 2005 | 2004 Legislative Agenda | 2004 Priorities

2004 State Budget and Related Information

The following is a brief summary of highlights of the 2004-05 Executive Budget,
released on January 20, 2004:

Reform of Long Term Care:

• State 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 insurance options.
• 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%.

Pharmaceutical Savings:

• Controlling drug costs – measures are designed to save Medicaid program $93 million and EPIC $60 million.
  1. Establish 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.
  2. 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.
  3. Forge Proof Prescription Program – require use of non-reproducible prescription forms for both controlled and non-controlled substances.
  4. 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.
  5. 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.

Affordable 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.

Supplemental Nutrition Assistance Program:

• Funding maintained at $17.2 million.