A shift in costs under the Medicaid program from the state to New York City government remains in Gov. Andrew Cuomo’s proposed $154 billion budget his Medicaid czar on Monday told lawmakers.

State Medicaid Director Jason Helgerson, however, testified at a state budget hearing in Albany the cost shift could be avoided if “efficiencies” are found ahead of the budget approval.

“We’ve heard loud and clear from the city of New York about the change,” Helgerson said at the hearing during questioning from Bronx Democratic Sen. Gustavo River. “We certainly do not want this to negatively effect the citizens of the city of New York.”

Helgerson added there is “a desire to have an open dialogue with” city officials over the cost shift, which in its first year is estimated to be about $195 million.

“We’re committing to working with the city to find efficiencies,” he said.

The move was one of several proposed budget actions New York City officials saw as being to the detriment of the city and Mayor Bill de Blasio’s administration. The proposed spending plan also sought more funding from the city for the City University of New York.

A day after presenting his budget this month, Cuomo defended some of the proposals in the plan that impact New York City, ultimately declaring in an interview the provisions “won’t cost New York City a penny.”

The mayor, who has been locked in a public feud with the governor since July, is due to testify in Albany before lawmakers at a joint budget hearing on Tuesday.