In New York, where Medicaid managed long-term care has been implemented for a while now, they are beginning to see two distinct trends: that the HMO’s are looking to enroll healthier elders in Medicaid, and that these same HMOs were “dumping” sicker, more medically frail Medicaid recipients from their plans, or refusing to assess them. New Jersey’s Comprehensive Waiver looks to involve managed care plans in the provision of all Medicaid long-term care services, so this is something New Jersey Medicaid needs to study closely so that they do not allow these New York trends to repeat themselves “across the river.”