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Medicaid

Resident Geri Mariano’s Trying Experiences with Medicaid Managed Care

April 24, 2017 by The Inside Press

By Grace Bennett and Janie Rosman

Geri Mariano
PHOTO BY RICHARD CAPLAN

Geri Mariano (also known as Geralyn Pinciaro), a much beloved Armonk resident with a myriad of health care needs, has hit too many brick walls in her odyssey through the health care morass. Inside Armonk contacted local and state officials with the goal of spotlighting her situation…in the hopes that Geri can receive the care she deserves and within her means.

“Geri Mariano imbues the spirit of the community and pride in her hometown, and it in her,” State Assemblyman David Buchwald stated when contacted to discuss Geri’s recent issue with obtaining optimal health care to address her unique medical needs. “What saddens me so much is that health care policy hasn’t done right by her, most recently in June 2016.”

Background

Governor Andrew M. Cuomo’s Executive Order No. 42 regarding Medicaid redesign was to cover recipients who have long-term disabilities and chronic health problems such as diabetes, heart disease, substance abuse and mental illness. Some constituents like Geri Mariano found their coverage changed as a result of the Governor’s April 12, 2012, directive, which established a state-based health benefit exchange per the Affordable Care Act.

Born at White Plains Hospital in October, 1967 with Diastrophic Dysplasia/Dwarfism, Geri was abandoned at birth by the biological parents. It wasn’t until she was 18 months that then Geralyn Pinciaro was taken in by William and Doris Mariano after her story appeared in the Gannet Newspaper. She was raised in a loving home; yet never legally adopted, Mariano was an official “Ward of the State” and remained under Department of Social Services’ protection until she turned age 18. Afterwards she went years without needing re-approval for Medicaid coverage.

Approximately 10 years ago, she would be re-certified every other year or so. When she received a letter stating she would be moved from Straight Medicaid in January. 2013, she asked NYS Assemblyman David Buchwald (93rd A.D.) to intervene on her behalf. After a few calls, the Assemblyman’s Office found there had been a mistake and Mariano’s status was not supposed to change; her status was changed back.

A letter last summer mandated Mariano to enroll in a managed care plan by July 31, 2016. As no exemptions for Medicaid enrollees applied to her situation, she was automatically enrolled in MVP Medicaid Managed Care. As a result of the change, Mariano can’t see her PCP whose office is in downtown Armonk and has been accommodating and an advocate for her for over 20 years. Additionally, her aides took an unexpected pay cut due to the coverage switch. And the prosthetist who got Mariano up and walking again after several years is not covered. After making much progress regaining the ability to walk, Mariano has not been upright since November, 2016.

Mariano was the first special needs student with a physical disability to be enrolled in Byram Hills School District in 1972 without the Federal Mandate to do so; she graduated in 1985. Mariano graduated from Smith College n 1989, one of its first matriculated students with congenital disabilities. In 2013, she received the Spirit of Independence Award from Westchester Disabled on the Move in Yonkers. “We all want to assist Geri, whom I have known for many years growing up in Armonk,” said Westchester County Legislator Margaret A. Cunzio, representing District 3 (Mount Pleasant, Pleasantville and parts of North Castle) “Anything we can do to bring this issue to the forefront and seek assistance from New York State is imperative.”

Her two Fair Hearing appeals (when no  representatives from DSS or Medicaid Choice showed up) were denied last fall. Mariano was informed by the Hearing Judge that his decision could be overturned but that she would not be made aware if in fact it was. Mariano is frustrated to not know if the Hearing Judge ruled in her favor and the decision was overturned by Albany. Mariano reached out to friends for advice with her predicament, one of whom posted her situation in the Facebook group, Armonk Moms. At press time, discussions have started whether a letter writing campaign and rally would help bring wider attention to this matter.

The Inside Press has since reached out to the Governor’s press office, the New York Department State of Health, Representative Nita Lowey (D-NY17) and State Senator George Latimer (37th S.D.). As this is a State matter specifically, Roy Loewenstein of Lowey’s office, suggested the State could provide the most comprehensive answers.

A letter was being drafted by Andrew Ferris in State Senator Latimer’s office, and awaits signatures by the senator and Assemblyman Buchwald. “There’s no hardship exemption, where someone says, ‘What’s best for Geri given her situation?’” Buchwald said. “My role is to try to cut through the bureaucracy as the system is not designed for folks like Geri.”

At press time we are awaiting a response from the state. Mariano wants an opportunity to share her story with Gov. Cuomo’s administration representatives and relate that the present exemptions DO NOT fit every situation of those who have had coverage throughout their entire lives. States Geri: “There are others in the same boat. I need to be their voice, too.”

Grace Bennett is publisher and editor of the Inside Press, which she founded in 2003. Janie Rosman is a freelance writer and editor whose work appears in local and regional publications. She chronicles the Tappan Zee Bridge replacement project at Kaleidoscope Eyes.

Filed Under: Armonk Cover Stories Tagged With: Armonk Residnt, Disabilities, Geri Mariano, Managed Care Challenges, Medicaid

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