Two weeks ago, New York State reached an agreement on a final Enacted Budget for Fiscal Year (FY) 2025, which runs from April 1, 2024 to March 31, 2025. The Budget is expected to propose total spending of $237 billion, a $4 billion increase from the Executive proposal of $232.7 billion, although not all documents have been published yet.
The final Enacted Budget does not include funding from a managed care organization (MCO) tax. The Legislature had sought to enact such a tax to add $4 billion of funding for Medicaid, but this will require federal approval. Instead, the Budget provides authority to the Executive to negotiate such a tax and hold the funds in a special Healthcare Stability Fund. Despite this, the Budget modestly increases Medicaid spending over the Executive Budget proposal.
Some of the most notable health care items in the Budget include:
- Aggregate Medicaid reimbursement increases on top of across-the-board increases in the last two years, for hospitals ($525 million all funds), nursing homes ($285 million all funds), and Assisted Living Programs ($15 million all funds).
- A Cost of Living Adjustment (COLA) for human services agencies of 2.84% (up from the Executive’s proposed 1.5%), with the additional provision that salaries for frontline staff must increase by at least 1.7%. As in the Executive Budget, the same entities are eligible who received last year’s COLA, except for Care Coordination Organizations (CCOs).
- The establishment of a single Statewide Fiscal Intermediary (FI) in the Consumer Directed Personal Assistance Services (CDPAS) program. The Statewide FI must be an entity that is currently serving as statewide FI for another state. It will employ several subcontractors, including at least one per rate-setting region, which must be entities with existing FI experience. Other than these entities, no other FIs will be allowed to continue operating after April 2025.
- The Governor’s Healthcare Safety Net Transformation program for partnerships to stabilize distressed safety net hospitals, with an anticipated $300 million in funding.
- Creation of a Community Advisory Board for SUNY Downstate and postponement of any reduction in capacity there until at least April 2025.
- Most of the Governor’s proposed consumer protections, including:
- An expanded, mandatory uniform hospital financial assistance policy, with a new clarification that immigration status may not be considered in the process.
- Requirement that separate patient consent must be obtained for treatment and payment.
- Limits on medical financial products, such as medical credit cards.
- Implementation support for the State’s new 1115 Medicaid waiver amendment.
SPG’s summary, which provides further detail on these and other highlights from the Budget, can be found here. The Governor’s press release on the Budget is available here.