Current through Register Vol. 46, No. 39, September 25, 2024
WHEREAS, New York State spends more than twice the national
average on Medicaid on a per capita basis and spending per enrollee is the
second highest in the nation;
WHEREAS, New York ranks 21st out of all states for overall
health system quality and 50th for avoidable hospital use and costs;
WHEREAS, New York's Medicaid program struggles within a
disjointed, sprawling administrative structure;
WHEREAS, New York's Medicaid payment system often creates
financial disincentives for the delivery of high-value, cost-effective, quality
health care;
WHEREAS, New York State faces serious financial challenges
in achieving a balanced budget in the 2011-12 State Fiscal Year;
WHEREAS, New York State's current fiscal constraints
necessitate specific budget reductions for Medicaid spending; and
WHEREAS, it is of compelling public importance that the
State conduct a fundamental restructuring of its Medicaid program that achieves
measurable improvement in health outcomes, sustainable cost control and a more
efficient administrative structure;
NOW, THEREFORE, I, Andrew M. Cuomo, Governor of the State
of New York, by virtue of the authority vested in me by the Constitution and
laws of the State of New York, do hereby order as follows:
A. Definitions
As used herein, the following terms shall have the
following meanings:
1. "State agency"
or "agency" shall mean any state agency, department, office, board, bureau,
division, committee, council or office.
2. "Public authority" or "authority" shall
mean a public authority or public benefit corporation created by or existing
under any New York State law, with one or more of its members appointed by the
Governor or who serve as members by virtue of holding a civil office of New
York State, other than an interstate or international authority or public
benefit corporation, including any subsidiaries of such public authority or
public benefit corporation.
3.
"State officer or employee" shall have the meaning given in Section
73 of the
Public Officers Law.
B.
Medicaid Redesign Team
1. There is hereby
established the Medicaid Redesign Team ("Team") that shall exist to provide
guidance for, and advice to, the Governor.
2. The Governor shall appoint up to 25 voting
members of the Team. The members of the Team shall include: state officers or
employees with relevant expertise; two members of the New York State Assembly,
one recommended by the Speaker of the Assembly and one recommended by the
Minority Leader of the Assembly; two members of the New York State Senate, one
recommended by the Temporary President of the Senate and one recommended by the
Minority Leader of the Senate; and stakeholders with expertise in areas such
as:
a. health care delivery;
b. health care insurance;
c. health care workforce;
d. economics;
e. business;
f. consumer rights; and
g. other relevant areas.
3. Vacancies shall be filled by the Governor,
and the Governor may appoint additional voting and non-voting members to the
Team as necessary. Members of the Team shall serve at the pleasure of the
Governor.
4. The Governor shall
designate a Chair or Co-Chairs from among the members of the Team.
5. The Governor shall appoint the New York
State Medicaid Director as Executive Director of the Team.
6. The Director of the Budget shall serve as
an ex officio, non-voting member of the Team.
7. A majority of the total members of the
Team who have been appointed shall constitute a quorum, and all recommendations
of the Team shall require approval of a majority of its total
members.
8. The Team shall attempt
to engage and solicit the input of a broad and diverse range of groups,
organizations and individuals.
C. Cooperation with the Team
1. Every agency or authority of New York
State shall provide to the Team every assistance and cooperation, including use
of New York State facilities, which may be necessary or desirable to fulfill
the purposes of this Executive Order.
2. Staff support necessary for the conduct of
the Team's work may be furnished by agencies and authorities (subject to the
approval of the boards of directors of such authorities).
D. Duties and Purpose
1. The Team shall engage Medicaid program
stakeholders for the purpose of conducting a comprehensive review of and making
recommendations regarding the Medicaid program, which shall include specific
cost saving and quality improvement measures for redesigning the Medicaid
program to meet specific budget reductions for Medicaid spending. The Team's
review and recommendations shall address matters including but not limited to:
a. existing programs in New York State and
across the country that have resulted in Medicaid savings and improved
quality;
b. existing programs in
New York State that consume a disproportionate share of Medicaid
dollars;
c. opportunities in the
federal Patient Protection and Affordable Care Act that can help strengthen
both the fiscal and care delivery models of New York State's Medicaid
program;
d. the utilization of
Medicaid services by overall volume, site of service, and beneficiary
group;
e. new models of health care
delivery to improve care management for beneficiaries with complex health
conditions;
f. existing regulations
that are outdated, redundant, or hinder the modernization of the Medicaid
program;
g. potential cooperative
efforts with the federal government to improve coverage, cost, and quality
within the Medicaid program; and
h.
the possible restructuring of Medicaid to achieve short-term solutions and long
term systemic changes.
2. At the direction of the Team, the
Executive Director shall notify stakeholders of the purposes of the Team, the
opportunities for stakeholder participation and the means and schedule for such
participation. Meetings with stakeholders shall be held in various regions of
New York State. Participating stakeholders may be assigned to specific working
groups, consistent with their areas of expertise and interest.
3. The Executive Director shall provide
parameters for the submission of proposals and recommendations by stakeholders
and other interested parties. After consultation with the Division of the
Budget, the Executive Director shall evaluate whether such proposals can be
feasibly implemented and if so, the savings that may be realized
therefrom.
4. The Team shall
commence its work no later than January 7, 2011. On or before March 1, 2011,
the Team shall submit its first report to the Governor of its findings and
recommendations for consideration in the budget process for New York State
Fiscal Year 2011-12. The Team shall submit quarterly reports on its continuing
review thereafter. The Team shall make its final recommendations to the
Governor not later than the end of the State Fiscal Year 2011-12, at which time
it shall terminate its work and be relieved of all responsibilities and duties
hereunder.
Signed: Andrew M. CuomoDated: January 5,
2011
