Medicaid Matters joined nineteen other advocacy groups to issue a statement on the August 2022 report by the Office of the State Comptroller regarding New York’s Medicaid Managed Long Term Care program, titled “Medicaid Program – Oversight of Managed Long-Term Care Member Eligibility.”
The statement’s introduction describes the consumer advocacy perspective on the OSC’s findings:
Over 300,000 New Yorkers who have disabilities rely on Medicaid community-based long-term care services to live safely and independently in their homes. As their advocates, we make this statement in response to the report released by the New York State Comptroller on Aug. 5, 2022, titled “Medicaid Program — Oversight of Managed Long-Term Care Member Eligibility,”1 [Hereinafter “OSC Report”]. We applaud the Comptroller for highlighting data that illuminates the lack of State oversight of Managed Long Term Care (MLTC) plans, which are paid over $15 billion each year to provide services to this vulnerable population. The OSC Report identifies two broad findings. The more costly and concerning finding—that NYS paid $2.8 billion in premiums to MLTC plans that provided little or no services to their members—takes up only two pages of the report.2 Most of the report focuses on a finding that $701 million was paid to plans for consumers who had died, moved to an Assisted Living Program, or were otherwise not eligible for MLTC. Unfortunately, neither of these distressing findings are surprising as we have consistently sounded the alarm on a lack of appropriate oversight and monitoring of plans by the NYS Department of Health [hereinafter “Department”]. We urge OSC and the Department to focus more oversight on the failure of plans to provide the appropriate level of care.
Download the consumer advocates’ statement here.