NY one-house budget resolutions repeal Medicaid carve out

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ALBANY, NY (WENY) — Gov. Kathy Hochul’s budget plan proposes a transition from Medicaid managed care plans to NYRx, a fee-for-service Medicaid program. But this week lawmakers repealed this transition in their one-house budget resolutions.

The Medicaid carve-out originated in the state’s 2020 budget. The implementation of the 2020 proposal was delayed for two years. The delay expires in about two weeks on April 1.

Some lawmakers said a repeal to the Medicaid carve-out would help avoid an interruption of services.

“We want to make sure that the delivery of healthcare and the things that hospitals are able to do based on 340b, that we still want them to be able to do that,” said Assembly Speaker Carl Heastie (D-Assembly District 83).

Some pharmacy advocates feel differently. They said this transition would expand needed access for Medicaid recipients to New York State pharmacies.

“The transition back to NYRx would be any willing provider which would allow of these pharmacies to be allowed back in-network and allow patients to access what might be the most accessible pharmacy to them,” said Heather Ferrarese, President of the Pharmacists Society of the State of New York.

Some local county leaders said this transition could be beneficial for Medicaid patients to access their medications–especially in rural counties.

They also said it could have an impact on the fiscal forecast that the Division of Budget uses to estimate the cost of Medicaid.

“So, the Medicaid program, wherever the state can find those efficiencies, especially if they are basing budget estimates on that. If they can do that in a way that does not harm recipients, in my opinion it’s a good thing,” said Jack Wheeler, Steuben County Administrator.

The one house budget resolutions passed in the Senate and the Assembly Thursday. Lawmakers now head into negotiations with the governor. The final budget plan is due in two weeks on April 1.


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