Eligibility Simplification Project for New York State Department of Health

Grantee Name

Center for Children and Families, Georgetown University Health Policy Institute

Funding Area

Expanding Health Care Coverage

Publication Date

April 2011

Grant Amount

$50,000

Grant Date:

November 2007 – October 2008

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Although New York State has a relatively broad set of health insurance coverage options available to its residents below certain income levels, the public has trouble understanding their eligibility for these programs.

Additionally, health care providers, State and county staff, and other stakeholders often have difficulty navigating who is eligible for what. To address this issue, the New York State Department of Health’s Office of Health Insurance Programs (OHIP) asked NYHealth to engage the Center for Children and Families (CCF) at Georgetown University’s Health Policy Institute to determine which changes to State law would be possible under Federal law to simplify coverage options and improve program participation rates. CCF then conducted a study to review the New York State Medicaid program’s multiple and overlapping eligibility categories and recommended options for OHIP to collapse and simplify those categories.

This project was part of a larger NYHealth authorization that funded a series of quick-strike analyses to help the New York State Department of Health’s (NYSDOH’s) Office of Health Insurance Programs find ways to streamline and expand its public health insurance programs.

Read an NYHealth special report that contains a summary of findings from this authorization.

Outcomes and Lessons Learned

Researched New York State’s eligibility categories in Medicaid, Child Health Plus, and Family Health Plus, reviewing State law, State regulations, State eligibility manuals, and eligibility computer system coding.
Contacted OHIP staff to seek further information on questions that arose during the research phase.
Met with OHIP staff in Albany to review the project’s objectives and early findings to solicit feedback and input on possible options, and—with the OHIP’s permission—met with non-agency New York State experts to solicit their input on these options.
Prepared a draft report on the family, children, and childless adult categories.
Conducted further research on the elderly and disabled categories, and prepared a draft report focused on those categories.

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