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New York Requires Employed Medicaid Recipients To Enroll in Employer-Sponsored Health Insurance

HRD-84-86 Published: Aug 10, 1984. Publicly Released: Aug 10, 1984.
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Highlights

As a part of its review of the use of recipient health insurance coverage to avoid Medicaid costs, GAO reported on the New York State practice of requiring working recipients to enroll in available employer-sponsored health insurance plans.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Health Care Financing Administration The Administrator of the Health Care Financing Administration (HCFA) should direct the New York State Medicaid agency to discontinue the practice of requiring Medicaid recipients to enroll in employer-sponsored health insurance as a condition for eligibility until, and unless, it seeks demonstration project status for this practice and HCFA approves the necessary waiver.
Closed – Implemented
HCFA told New York State that its practice was contrary to federal law and to discontinue or modify the practice to bring it into conformance. HCFA instructed states to consider free employer-provided health insurance and state paid premiums for employer-sponsored health insurance as conditions for coverage of services rather than as a condition of elgibility for Medicaid.

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Topics

Cost controlEligibility criteriaFederal regulationsstate relationsHealth care servicesHealth insuranceWaiversMedicaidHealth careMedicaid program