Updates & Analysis

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…

On July 19th, the New York State Department of Health (DOH) issued a request for stakeholder input regarding the next round of health care capital grants under the Statewide Health Care Facility Transformation Program (SHCFTP). As required by statute, DOH is seeking comment regarding program eligibility, award criteria and the process for making awards under…

On July 13th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. The proposed rule updates Medicare payment policies and rates for hospital outpatient departments, ASCs, and partial hospitalization services furnished by community mental health providers.…

On June 22nd, the New York State Department of Health (DOH) hosted its quarterly Children’s Medicaid Redesign Team (MRT) webinar outlining key updates regarding the Children’s 1115 MRT Waiver submission. In particular, the webinar discussed important modifications in the most recent submission, including: Once approved, the Children’s 1115 MRT Waiver will be implemented Statewide; The…

On June 20th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would implement changes to Quality Payment Program (QPP). The first payment year is scheduled to begin in 2019. As required by the Medicare Access and CHIP Reauthorization Act, base payment rates for services under the Physician Fee Schedule will…