Updates & Analysis

On August 25th, the New York State Department of Health hosted a webinar to discuss requirements in the Medicaid Value-Based Payment (VBP) Roadmap to implement social determinants of health (SDH) interventions. By incentivizing providers and managed care organizations to address the underlying drivers of health outcomes, the State hopes to improve population health while reducing…

On August 22nd, the NYC Department of Mental Health (DOHMH), in collaboration with Public Health Solutions (PHS), released a Concept Paper for a forthcoming Request for Proposals (RFP) for the Ryan White Part A Funded Services Care Coordination Program. This program, for which there is $21,072,362 allocated for the first contract year, will provide funding…

On August 15th, the New York State Department of Health (DOH) released for public comment the draft Transition Plan for the Children’s Medicaid System Transformation, which describes the State’s overall approach to implement children’s Health Homes, roll out the six new State Plan Amendment (SPA) services and newly aligned children’s Home and Community Based Services…

On August 15th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would make changes to the CJR model and cancel several other mandatory payment models that were finalized but not implemented under the Obama Administration. CMS will accept comments on the proposed rule until October 14th. A summary of major…

On August 7th, the New York State Office of Mental Health (OMH) released a Request for Proposals (RFP) for a not-for-profit organization to assume operational responsibility for a 24-bed licensed Community Residence (CR) Program and a 22-bed Scattered Site Supportive Housing (SH) Program in Brooklyn. All housing residents are adult males from the Jewish Orthodox…

On August 4th, the New York State Office of Health Insurance Programs released the final application for the Managed Long Term Care (MLTC) Workforce Investment Program, which is part of the State’s Medicaid Section 1115 Waiver. The program provides up to $245 million in funding to retrain, recruit and retain long term care workers, and…

On July 31st, CMS released a final rule for federal FY 2018 Medicare payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the IRF Quality Reporting Program (IRF QRP). A summary of major provisions of the rule is attached. The final rule is available here.

On July 21st, New York State announced that the Centers for Medicare and Medicaid Services (CMS) have approved a retroactive rate increase for several of the Behavioral Health Home and Community Based Services (BH HCBS) available to qualifying members of Health and Recovery Plans (HARP) and HIV Special Need Plans (HIV SNP). A short summary…

On July 25th, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would update Medicare payment rates for home health agencies (HHAs) in CY 2018, implement a new case-mix methodology for CY 2019, and update reporting requirements to comply with provisions of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act for…

On July 27th, CMS issued a proposed rule that would implement $43 billion in Medicaid DSH payment reductions between federal FYs 2018 and 2025. Legislation has subsequently delayed the cuts, most recently until September 30, 2017. Should the current proposal be implemented, CMS estimates that based on 2017 data New York would see DSH payment…

On July 24th, the New York State Department of Health (DOH) and Office for People with Developmental Disabilities (OPWDD) posted for public comment a draft amendment to the 1115 Medicaid Redesign Team (MRT) Waiver that would authorize the transition of individuals with intellectual and/or developmental disabilities (I/DD), and of the OPWDD service system, into managed…

On July 27th, the New York State Department of Health (DOH) Medicaid Redesign Team (MRT) issued an update regarding progress of the Delivery System Reform Incentive Payment (DSRIP) program, which completed its second year of demonstration on March 31st. Notable progress updates include the following: Performing Provider Systems (PPSs) have earned 95% of all available…