Updates & Analysis

On September 4th, the New York State Department of Health (DOH) released a Request for Applications (RFA) for the local administration of Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) services that are part of the State’s Home and Community Based Services (HCBS) 1915(c) waiver programs. Over $45 million in total funding…

On August 23rd, the New York City Department of Youth and Community Development (DYCD) released a Request for Proposals (RFP) for the provision of Crisis Services and Transitional Independent Living (TIL) programs for homeless young adults (HYA) ages 21-24. Over $13 million in total funding will be allocated through this RFP to successful applicants who…

The New York State (NYS) Department of Health (DOH) has released new guidance that places a limit on the number of Licensed Home Care Service Agencies (LHCSAs) that a partially-capitated managed long-term care (MLTC) plan may contract with in its network. DOH was required to publish this guidance by provisions in the NYS Fiscal Year…

On August 8th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would redesign participation options for the Medicare Shared Savings Program (MSSP) under a new model referred to as “Pathways to Success.” The proposed rule would discontinue or replace all MSSP Tracks (1, 1+, 2, and 3) and implement two…

On August 1st, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to update the Medicare hospice payment rate for federal fiscal year (FY) 2019. The rule also finalizes changes to the scope of practice for physician assistants, Hospice Compare website, and Hospice Quality Reporting Program (QRP). Unless otherwise specified, the provisions…

On July 31st, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to update the federal fiscal year (FY) 2019 Medicare payment rates for skilled nursing facilities (SNFs) under the prospective payment system (PPS). The rule also finalizes changes to the case-mix classification system, SNF Quality Reporting Program (QRP), and Value-Based Purchasing…

On July 25th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed Hospital Outpatient Prospective Payment System (OPPS) rule that would update Medicare payment rates for hospital outpatient departments and ambulatory surgery centers (ASCs) for CY 2019. The rule would increase OPPS rates by 1.25%. However, proposed changes to off-campus Provider-Based Department payment…

On July 17th, New York State announced the approval of the annual update to the Value-Based Payment (VBP) Roadmap for Year 3. The Roadmap is part of the Delivery System Reform Incentive Payment (DSRIP) program and outlines the State’s plan to make 80% of Medicaid managed care payments through VBP arrangements by the end of…

As part of the Children’s Medicaid System Transformation, New York State intends to implement six new behavioral health services under the Early and Periodic Screening and Diagnostic Testing benefit in the Medicaid State Plan. These newly established services will offer new community-based supports to Medicaid-enrolled individuals under the age of 21 who meet medical necessity…

On July 19th, the New York State (NYS) Department of Health (DOH) issued a Request for Information (RFI) seeking public input on public need criteria for the licensure of Licensed Home Care Services Agencies (LHCSAs). The NYS Enacted Budget for 2018-19 included a provision to limit the number of LHCSAs by authorizing the Public Health…

On June 28th, the New York City Human Resources Administration’s Department of Social Services released a Request for Proposals (RFP) for the provision of scattered-site supportive housing for young adult families. This housing consists of scattered-site apartments located in multiple buildings integrated into the community, intended to provide residents with affordable, independent housing and access…

On July 12th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would update the Physician Fee Schedule and a number of other Medicare payment policies and programs, including updates to the Medicare Shared Savings Program and the Quality Payment Program. Proposed changes impact numerous areas of Medicare reimbursement and reporting,…