News & Analysis as of

Medicaid › New York

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
McDermott Will & Emery

Budget reconciliation’s effect on New York’s Medicaid and Essential Plan funding

McDermott Will & Emery on

The budget reconciliation process resulting in the One Big Beautiful Bill Act, which was enacted on July 4, 2025, contains many significant changes to the Medicaid program. Many of the changes, such as those related to work...more

Rivkin Radler LLP

NY Medical Transport Owner Sentenced for Medicaid Fraud

Rivkin Radler LLP on

The owner of Sublime Medical Transportation in Schenectady County, New York was recently sentenced to three to nine years in state prison for orchestrating a large Medicaid fraud scheme. Muhammed Adnan Saeed netted over...more

Sheppard Mullin Richter & Hampton LLP

Policy Brief: Aligning Nursing Home Bed Planning with New York’s Certificate of Need Reform Goals

Sheppard Mullin Richter & Hampton LLP on

Last month, New York State began a formal review of its Certificate of Need (CON) process for nursing homes, launching a timely conversation about how best to align regulatory oversight with evolving system needs. A new...more

Troutman Pepper Locke

New York AG Intensifies Investigation and Enforcement Against Alleged Medicaid Fraud

Troutman Pepper Locke on

On June 30, 2025, New York Attorney General (AG) Letitia James announced new lawsuits, criminal charges, and settlements with 25 New York transportation companies related to alleged schemes to defraud Medicaid of millions....more

Harris Beach Murtha PLLC

OMIG Announces 12-Month Review Period for its Compliance Program Reviews

Harris Beach Murtha PLLC on

The New York State Office of the Medicaid Inspector General (“OMIG”) issued a Listserv Notice on June 26, 2025 advising that its Compliance Program Reviews (“CPRs”) beginning after July 1, 2025, will use a 12-month Review...more

Sheppard Mullin Richter & Hampton LLP

New York’s Master Plan for Aging: What Legal, Health, and Policy Leaders Need to Know

Sheppard Mullin Richter & Hampton LLP on

On June 30, 2025, New York State released its long-anticipated Master Plan for Aging (MPA), a 10-year strategic framework designed to improve the way the state supports older adults, individuals with disabilities, and family...more

Sheppard Mullin Richter & Hampton LLP

Understanding the Federal Reconciliation Bill’s Implications for MCO Tax Structure

Sheppard Mullin Richter & Hampton LLP on

New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more

Bond Schoeneck & King PLLC

Destabilizing Federal Medicaid Proposals Dangle Like Damocles’s Sword Over New York’s Health Care System

Bond Schoeneck & King PLLC on

New York State’s FY '26 budget is balancing precariously on a banana peel. Although Governor Hochul finally approved the budget in May after a weekslong standoff with the legislature, the budget rests on assumptions that...more

Mintz - Health Care Viewpoints

New York Department of Health Publishes Material Transactions Reporting Form

Mintz - Health Care Viewpoints on

In our February 14, 2025 blog post, we detailed a proposed expansion of Article 45-A of New York’s Public Health Law (hereinafter, the Disclosure of Material Transactions Law) included in the proposed Fiscal Year 2026 New...more

Cozen O'Connor

Policy Alert: New York State Passes FY26 Budget

Cozen O'Connor on

Yesterday, state lawmakers passed the $254B FY26 state budget, reflecting an increase of $17B from FY25. The budget was passed over five weeks after the deadline of April 1, and will be retroactively in effect from April 1,...more

Littler

DOJ Files a Statement of Interest in a Federal Lawsuit Against the NY Department of Health and Court Issues a Preliminary...

Littler on

As previously discussed, in Engesser v. McDonald, a class of Medicaid beneficiaries who receive personal care and home care services through New York’s CDPA Program (Consumers), and two independent living centers...more

Littler

NY Federal Court Issues TRO Against the NY Department of Health

Littler on

As previously reported, in April 2024, New York’s Social Services Law was amended to include a substantial change to the state’s Consumer Directed Personal Assistance Program (CDPA Program), a Medicaid-funded program allowing...more

Littler

New York Court Issues Decision and Order Declaring the DOH’s August 2024 Reimbursement Rate Adjustment for Fiscal Intermediaries...

Littler on

On March 20, 2025, a New York Supreme Court Justice in Albany County issued a decision and order declaring the New York State Department of Health (NY DOH)’s August 2024 implementation of an administrative rate reimbursement...more

Rivkin Radler LLP

The Status of Providing Gender-Affirming Care to Minors in NY

Rivkin Radler LLP on

In recent months, Executive Orders issued by the current Administration regarding gender-affirming care of minors have been the subject of much debate and litigation. The crux of these lawsuits is largely two Executive...more

McDermott Will & Emery

New York Executive Budget Proposes Amendments to MCO Provider Tax

McDermott Will & Emery on

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

Rivkin Radler LLP

Owners of Transportation Company Defrauded Medicaid of $3.8M

Rivkin Radler LLP on

The New York State Attorney General’s Office announced on December 5 that Muhammad Rizwan Khan, Muhammad Usman Khan and Farhan Khan and their Orange County-based transportation companies, Tristate Express NY, Inc., Meditrans...more

Rivkin Radler LLP

Eight Charged in $68 Million Brooklyn Medicaid Fraud Scheme

Rivkin Radler LLP on

Eight individuals associated with two Brooklyn social adult day care centers and a home health care intermediary have been charged in an alleged $68 million Medicaid fraud scheme. The defendants, including owners and staff...more

Rivkin Radler LLP

$68 Million CDPAP Fraud Indictment Unsealed Amidst Industry Changes

Rivkin Radler LLP on

On October 9, 2024, the United States Attorney’s office in the Eastern District of New York unsealed an indictment alleging that eight defendants defrauded Medicaid of approximately $68 million. The alleged scheme involved...more

Falcon Rappaport & Berkman LLP

Pooled Income Trusts for Medicaid Home Care

Falcon Rappaport & Berkman LLP on

One of the biggest misconceptions related to Community (Home Care) Medicaid is the idea that one thinks they and/or their loved one is not eligible for services because “they make too much money.” In New York State, for one...more

McDermott Will & Emery

New York State Budget Institutes Revenue-Neutral Health Plan Tax

McDermott Will & Emery on

The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been...more

McDermott+

Policy Update - New York 1115 Waiver Amendment Timeline for Medicaid Hospital Global Budget Initiative

McDermott+ on

A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and...more

Sheppard Mullin Richter & Hampton LLP

2024 Brings Expansion to Medicaid in New York State

Sheppard Mullin Richter & Hampton LLP on

On Tuesday, January 9, 2024, the Centers for Medicare & Medicaid Services (“CMS”) approved a request from New York State (“NYS”) to amend its Medicaid section 1115(a) demonstration (the “Demonstration Amendment”),[1] which...more

Proskauer - Health Care Law Brief

Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State...

Proskauer - Health Care Law Brief on

On Tuesday, January 16, 2024, Governor Kathy Hochul released the SFY 2025 New York State Executive Budget (“Executive Budget”). While still subject to legislative approval, the Executive Budget incorporates the recently...more

Harris Beach Murtha PLLC

NYS DOH Seeks Grant Applications for Health Equity Social Care Networks

Harris Beach Murtha PLLC on

The New York Department of Health (DOH) recently announced it is accepting applications for New York Health Equity Reform: Social Care Networks regional grants. The nine regional grants will distribute a total of $500 million...more

Lippes Mathias LLP

New York State Medicaid Updates for 2024

Lippes Mathias LLP on

Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more

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