On April 10th, the Provider Associations and the Commissioner’s Advisory Panel met to more fully discuss the plan for how the $90 million dollar reduction in payments to not-for-profit OPWDD providers will be implemented. This is what was presented:
$40 million will be applied to the cut from a combination of OMIG audits, self-disclosure and claims voided by providers received in the 2013-14 state fiscal year – the $40 million is state share so the total anticipated recoveries amounts to $80 million with the federal match. These savings have no impact on rates.
$32 million will come from savings derived from movement of individuals from higher cost services to lower cost services including movement from state institutions and prevention of out of state placements. Cost savings from avoiding “institutional” placements will also count. The total reduction will amount to $64 million with the federal match. These savings have no impact on rates.
$6.6 million in savings will be achieved through recent enrollment of 2,500 additional qualifying individuals into Medicare, thereby reducing Medicaid spending for medical services. These savings have no impact on rates.
$6 million will come from reducing payments for IRA and Community residences room and supplemental payments (currently $57 million per year) starting 10/1/13. This will be administered based on a surplus/ loss analysis of providers across all OPWDD Medicaid programs. Currently, 164 agencies receive this State payment and the 11% cut will be allocated to higher surplus agencies (with adjustments for 2011 rate cuts). OPWDD will work with Provider Associations on the exact methodology for allocating the cut. Whether agencies that had operated at a loss during that period will receive any reduction’s at all in this area is uncertain at this time. This cut is in state only dollars so the total impact remains at $6 Million.
$2.6 million savings ($5.2 million state and federal combined) will come from reducing the administrative portion of rates for ICF, day hab and res hab programs. To be implemented 10/1/13 together with rate rationalization. OPWDD estimates that it’s only a 1-2% reduction in the admin portion of rates.
$3 million in savings will come from transitioning individuals from sheltered workshops to integrated community employment. This is about an 8% reduction in OPWDD Local assistance funding for sheltered workshops effective 10/1/13.
The above figures of reductions are all annual figures.
Marco R. Damiani
Executive Vice President
YAI Network
and
Chair, Manhattan Developmental Disabilities Council
marco.damiani@yai.org
T 212.273.6188 | F 212.273.6590