New York City Council Header
File #: Res 0021-2004    Version: * Name: State to simplify the enrollment and recertification process to end the practice of "churning" of Medicaid managed care recipients.
Type: Resolution Status: Filed
Committee: Committee on Health
On agenda: 2/4/2004
Enactment date: Law number:
Title: Resolution calling on the State to simplify the enrollment and recertification process to end the practice of “churning” Medicaid managed care recipients, and thereby ensure access to consistent, long-term, preventive health care and achieve cost savings as intended by the system.
Sponsors: Helen D. Foster, Maria Baez, Charles Barron, Yvette D. Clarke, Robert Jackson, Margarita Lopez, Miguel Martinez, Michael C. Nelson, Joel Rivera, James Sanders, Jr., Larry B. Seabrook, Kendall Stewart, Albert Vann, David I. Weprin, Christine C. Quinn, Letitia James
Council Member Sponsors: 16

Res. No. 21

 

Resolution calling on the State to simplify the enrollment and recertification process to end the practice of “churning” Medicaid managed care recipients, and thereby ensure access to consistent, long-term, preventive health care and achieve cost savings as intended by the system.

 

 

By Council Members Foster, Baez, Barron, Clarke, Jackson, Lopez, Martinez, Nelson, Rivera, Sanders, Seabrook, Stewart, Vann, Weprin, Quinn and James

 

                          Whereas, The Medicaid managed care system in New York State has developed a pattern of enrollment and disenrollment, or “churning,” of people administratively on and off of the Medicaid rolls; and

Whereas, A recent report of the United Hospital Fund, entitled “Medicaid Managed Care in New York: A Work in Progress,” (the “Report”) found that complex enrollment and recertification requirements are the chief impediments to getting and keeping enrollees; and

Whereas, The Report found that Medicaid managed care plans have reported a turnover of almost half their members over the course of a year through involuntary disenrollment generally attributable to lost eligibility; and

Whereas, This “churning,” or rapid turnover, of recipients is due to a variety of reasons, such as patients’ failure to comply with paperwork requirements, local officials’ continued improper enforcement, and recipients finding jobs or changing addresses without making sure that the paperwork follows them; and

Whereas, This “churning” has resulted in people losing consistent access to preventive care and early detection services, thereby negating both the medical benefits and the cost savings intended by the change of Medicaid from fee-for-service to the managed care model; and

Whereas, The rapid turnover of enrollees has also meant an expensive duplication of paperwork and laboratory tests; and

Whereas, The Report called for changes in the Medicaid managed care program, including making it easier for people to enroll and stay enrolled; now, therefore, be it

Resolved, That the Council of the City of New York calls upon the State to simplify the enrollment and recertification process to end the practice of “churning” Medicaid managed care recipients, and thereby ensure access to consistent, long-term, preventive health care and achieve cost savings as intended by the system.