New York State Dept. of Health, 31 May 2006, Wednesday

Marcia Calicchia, Cornell University, School of Industrial and Labor Relations (Principal Investigator for Project) helped author the following study released online 31 May 2006, Wednesday.

Prepared for the Office of Medicaid Management,
New York State Department of Health
by Cornell University, School of Industrial and Labor Relations

Disaster Relief Medicaid: Evaluation Project [online 31 May 2006]
December 2005
http://www.health.state.ny.us/health_care/medicaid/related/docs/drm_report.pdf
[full-text, 214 pages]

[excerpts]
In the immediate aftermath of the September 11, 2001 World Trade Center disaster, access to ... needs-based programs was a serious concern.The infrastructure-supported communication with Medicaid computer systems suffered severe damage. Public transportation was disrupted. Information necessary to establish eligibility wasnot readily available. Faced with the likelihood of increased health care needs, and the inability to conduct business as usual, Governor Pataki?s office and the New York State Department of Health collaborated with the federal government and the New York City Human Resources Administration (HRA) in the hours and days after the attacks to create a new, time-limited program called Disaster Relief Medicaid/Family Health Plus (DRM).

DRM had several unique features:

-The program used a simplified, one-page application.? Applicants could attest to the information on their application, including income.?
-Eligibility generally was determined, and a Medicaid authorization form issued, on the spot. Applicants were presumed eligible if their income met the standards for Medicaid or Family Health Plus.?
-Participants received four months of coverage through traditional Medicaid providers.?
-At the end of the four months, participants could transition to regular Medicaid or Family Health Plus without a gap in coverage.?
-The coverage of existing Medicaid enrollees was renewed automatically.

The DRM program was unprecedented, and so was enrollment. Thousands of New Yorkers signed up between September 2001 and January 2002. Thus DRM became an unintentionallaboratory for examining the consequences of a radically simplified approach to government-funded health care.

CONTENTS
5 Executive Summary
6 Key Findings
10 Introduction16 Methodology
18 Profile of DRM Recipients and Utilization
25 Profile of Providers and Fraud and Abuse
34 MAP/HRA Process Analysis34 Pre-DRM Process
36 DRM Process38 Transitional Medicaid Process
40 Post-DRM Process47 Policy Implications
51 Background Information: Detailed History of Disaster Relief Medicaid
63 Appendices

Tables
Table 1. Difference between Traditional Medicaid and DRM
Table 2. Monthly Income Eligibility Level for Medicaid vs. DRM in NYC, 2001

Figures
36 Figure 1. Pre-DRM Workflow
38 Figure 2. Disaster Relief Medicaid Workflow
40 Figure 3. Transitional Medicaid Workflow
42 Figure 4. Model Offices Workflow
45 Figure 5. New York City Eligibility Determination and Enrollment Process