Contact: Sunny Mindel/Brenda Pérez (212) 788-2958
Barbara Flynn, (212) 788-2894
Office of the Health Advisor to the Mayor for Health Policy
Mayor Rudolph W. Giuliani today announced that the Health Care Financing Administration (HCFA), Department of Health and Human Services, has given its final approval to New York State to begin implementation of mandatory managed care in New York City.
There are 18 managed care plans in New York City. Individual Medicaid recipients must begin participation once they have received a mandatory notification letter from MAXIMUS, the State's enrollment broker. Medicaid recipients will have 60 days to choose a health plan and another 90 days to change to another plan after enrollment. A recipient who does not choose a health care plan within the first 60 days, will be automatically assigned to a health care plan. A recipient may change their plan at any time for a "good cause."
"By making primary care doctors available to individuals," Mayor Giuliani said, "we are expanding access to quality health services without having these individuals going to emergency rooms to seek treatment for a sore throat or for other primary care needs."
Dr. Rosa M. Gil, Special Advisor to the Mayor on Health Services expressed her support for the HCFA's green-lighting of the mandatory managed care system. She said, "This program presents the best opportunity for increasing the availability of quality primary care services, in addition to preventive and wellness services."
The first phase of the program is scheduled to begin in Staten Island, the southern half of Manhattan, and the southern half of Brooklyn. The program will be phased in over 2.5 years. As of April 1999, there were approximately 375,000 individuals who voluntarily enrolled in managed care. There are approximately 1.1 million additional persons eligible to participate in this new program.
Dr. Neal Cohen, New York City Health Commissioner, said, "From a public health standpoint, the implementation of mandatory managed care is a significant step in assisting New Yorkers to access primary and preventive care services. It is an important step toward reducing the inadequacies of the fragmented fee-for-service system."
Most Medicaid recipients will be required to join a health plan, with the exception of 18 categories of people, including persons with AIDS and persons with serious mental illness, who may voluntarily join a health plan, but are not required to do so. In addition, there are 16 categories of people, including persons living in residential care facilities and children in foster care, who are not permitted to participate in this new managed care program.
Mayor Giuliani and Dr. Gil, have initiated a comprehensive public education campaign -- New York Medicaid CHOICE -- to assist Medicaid consumers in choosing a health plan. A multi-media campaign has been developed by the City, State and MAXIMUS to inform the public about health plans and the general benefits of participating in managed care. The campaign will also assist health care providers in better understanding how the mandatory managed care program will operate. MAXIMUS is a private for-profit company selected by the State Department of Health's Office of Managed Care, and jointly funded by New York City, to provide enrollment, education and outreach services to Medicaid consumers.
"The New York Medicaid CHOICE program represents the City's efforts to make health care options more accessible and efficient for New Yorkers," said Dr. Gil. "The program is designed to reach out to help Medicaid consumers make educated choices about primary and preventive health care services for themselves and their families," Dr. Gil added.
New York Medicaid CHOICE has printed informational materials in five languages: English, Russian, Spanish, Haitian Creole and Chinese, and has also established a toll-free HelpLine information number (1-800-505-5678), staffed with enrollment counselors who speak nine different languages and can utilize the Language Line for translation services for more than 100 other languages. There is also a TTY/TTD number (1-888-329-1541) for the hearing impaired and special audiotapes for the blind. Medicaid consumers will be directed to contact the New York Medicaid CHOICE HelpLine.
Medicaid consumers can contact the New York Medicaid CHOICE HelpLine, 1 (800) 505-5678, from Monday through Friday from 8:30a.m. until 8p.m. New York Medicaid CHOICE offers consumers the opportunity to attend group presentations in their communities or face-to-face counseling sessions to help determine the best choice for themselves and their families.