Improving Program Administration
The federal government has given states broad latitude to administer Medicaid, within federal guidelines, since the program's enactment under the 1965 amendments to the Social Security Act. The administration of Medicaid in New York rests primarily with the State Department of Health, which serves as the State’s liaison to the federal government on Medicaid issues, works to ensure compliance with federal requirements, implements eligibility and benefits policies, oversees the Medicaid claims system, and establishes rates of payment for providers and health plans.
More than a dozen state agencies play roles in administering Medicaid. These include the Office of Mental Health, the Office of Mental Retardation and Developmental Disabilities, and the Office of Alcoholism and Substance Abuse—all of which administer programs funded primarily with Medicaid resources. In addition, New York City and the 57 county governments across the state play significant roles in administering Medicaid’s application and eligibility determination process, as well as authorizations for receiving certain long-term care services.
Related Publications
The Role of Local Government in Administering Medicaid in New York
Published: 2009
This report examines how multiple state agencies and 58 local governments share responsibility for administration of New York's Medicaid program.
Reforming New York's Medicaid Eligibility Process
Published: 2008
This Medicaid Institute™ report draws from the experience of selected states that have undertaken improvements in their Medicaid eligibility systems and processes, and identifies lessons that New York might consider as it seeks to improve its own Medicaid eligibility process.Presentation of “Health Care Financing Challenges for 2009 and Beyond”
Published: 2008
This presentation examines the major challenges related to financing health care in the United States and considers implications for New York’s Medicaid program.
Presentation of “Medicaid Spending in New York: Trends and Patterns, 2000-2005”
Published: 2006
Delivered at the Fund’s December 2006 "Dollars and Sense" conference, this presentation analyzes growth in enrollment and spending in New York’s Medicaid program from 2000 to 2005. As explained in the Medicaid Institute™’s subsequently published Medicaid in New York: A Primer, the unprecedented increase in enrollment among children and adults was not the primary driver of Medicaid cost growth over this period.Administration of Medicaid in New York State
Published: 2006
The administration of Medicaid in New York is dispersed among multiple agencies, with no single entity controlling more than a portion of the program. A groundbreaking Medicaid Institute™ study analyzes the program's organization, and its implications.Understanding the New State/County Paradigm
Published: 2006
With the new cap on the local share of Medicaid costs, it is New York State that will absorb the fiscal impact of all future changes to the program—and face unprecedented pressures, both fiscal and political, as a result, explains this new Medicaid Institute™ report.