County seeks $730K in Medicaid reimbursements

Coxsackie Town Councilman Patrick Kennedy addresses the Greene County Legislature about Medicaid payments in this 2018 file photo.

CATSKILL — The Greene County Legislature is poised to ask the state for nearly $730,000 in reimbursements for county taxpayers from certain Medicaid expenditures over four fiscal years.

According to a resolution passed by the Legislature’s Finance and County Services committees and up for approval by the full Legislature on Wednesday, written into the Affordable Care Act statute is “a requirement that, of the enhanced federal share of Medicaid that went to state governments, a proportionate share shall be paid to counties in states where they pay a portion of Medicaid costs, such as New York state.”

The state Department of Health manages these federal reimbursements by adjusting each county’s required weekly contribution to the cost of the Medicaid program, according to the resolution.

The Department of Health then estimates the enhanced Federal reimbursement, or eFMAP, that each county earns, through benefits paid out on behalf of that county’s Medicaid clients, and then reduces each county’s weekly shares by 80% of that number, according to the resolution.

The Department of Health is then required to calculate for each State Fiscal Year the difference between the “80% of projected eFMAP” figure by which each county’s weekly shares were reduced and that county’s actual eFMAP earned, and reimburse each county for that difference — a process referred to as “the eFMAP reconciliation.”

According to the resolution, the last time the Department of Health reported the reconciliation was 2015, and the estimated $729,596 is the county’s own calculation.

The Department of Health did not respond to requests for comment.

“The bottom line is it’s owed to us,” Legislature Chairman Patrick Linger, R-New Baltimore, said.

The county asks the state in the resolution to comply with the law set forth in the Affordable Care Act and to calculate the latest fiscal year’s reimbursement.

Copies of the resolution will be sent to elected officials including U.S. Sen. Majority Leader Charles Schumer, U.S. Sen. Kirsten Gillibrand, U.S. Rep. Antonio Delgado, Gov. Andrew Cuomo, state Sen. Majority Leader Andrea Stewart-Cousins, Assembly Speaker Carl Heastie, state Comptroller Thomas DiNapoli, state Sen. Michelle

Hinchey, Assemblyman Chris Tague and the New York State Association of Counties.

Linger said the county has fronted the cost.

“We’re a pretty small county, and over the last four years — add it all up,” Linger said.

Linger said the county has a number of projects up in the air that the money could be used for, including a new mental health building, a homeless shelter and programs to combat the opioid epidemic.

To the county, it’s unclear where the delay came from, Linger said.

“The state likes to balance its budget on the backs of property taxpayers,” he said.

Mark LaVigne, deputy director at the New York state Association of Counties, said this issue is affecting counties statewide and several counties have passed similar resolutions.

“It’s close to a billion dollars in funds that have not been transferred to the counties,” he said.

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Johnson Newspapers 7.1

(1) comment


Greene County seems to hav zero idea what to do with the $8 million received, already received, for COVID-19 relief.

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