Levy offers state Medicaid reform ideas

Suffolk County Executive Steve Levy urged the state to change the way it administers Medicaid so insurers do not reap excessive profits from patients who seldom use the system.

Social Services Commissioner Gregory Blass gave Levy's testimony Friday to Gov. Andrew M. Cuomo's Medicaid Task Force hearing at Hofstra University. It is one of several scheduled across the state aimed at finding billions of dollars in savings from the $53 billion a year in state program costs.

According to Levy aides, 20 percent of Suffolk's Medicaid managed care patients - 28,290 recipients - did not have a single health care visit last year. They said the state could save as much as $42 million a year by forcing managed care insurers to provide rebates or convert at least some of those patients to a fee-for-service arrangement.

Levy said in a news release that the state could also save about $15 million a year in Suffolk alone by requiring pharmacies to use generics instead of name brand drugs. Levy maintained that brand name drugs accounted for 29 percent of the prescriptions, but 80 percent of the total cost.

Levy also urged that the state centralize its administration of the Medicaid program, now spread among multiple state agencies and 58 local governments, and increase its management of the most costly patients rather processing applications.

Kevin Dahill, executive director of the Nassau-Suffolk Hospital Council, which represents the region's 24 hospitals, praised some of Levy's suggestions. He found the number who had no visits "startling."

But he cautioned that many may still be getting treatment elsewhere, such as costly emergency rooms. "Insurers who are being paid premiums should be held accountable for performance," he said. But he added any efforts to cut Medicaid patients who may not use services in any one year "would be penny wise and pound-foolish."