Updates & Analysis

On January 9th, Governor Andrew Cuomo delivered his 2017 State of the State speech in New York City as part of a series of deliveries across the state. The State of the State was accompanied by several health care-related proposals, including Regional Capital Investments and a Life Sciences Investment Initiative. Please find a summary of…

On December 29, 2016, the New York State Office of Mental Health (OMH) released two Requests for Proposals (RFPs) for the development and operation of new Congregate Supportive Housing units in mixed-use settings for adults with a serious mental illness (SMI) in Staten Island. Both capital and operating funding will be available to organizations who…

On December 20th, the New York State Department of Health posted a report on the Intellectually/Developmentally Disabled (IDD) eligible subpopulation from the IDD Value-Based Payment (VBP) Clinical Advisory Group (CAG).  The report describes the proposed VBP arrangement design and summarizes the quality measures for VBP arrangements for the Medicaid IDD-eligible subpopulation. This document summarizes aspects…

On December 16th, CMS published the Final Benefit and Payment Parameters for the 2018 plan year. The final rule implements several proposed changes to the marketplaces designed to improve the risk pool for insurers by limiting special enrollment periods, strengthening the risk adjustment program, and implementing a reinsurance fund as part of risk adjustment. The…

On December 9th, the New York State Department of Health (DOH) posted a report on the Long-Term Care eligible subpopulation from the Managed Long-Term Care (MLTC) Value-Based Payment (VBP) Clinical Advisory Group (CAG). The CAGs were convened to provide recommendations about how to define various aspects of the VBP arrangements included in the Delivery System…

On December 13th, President Barack Obama signed the 21st Century Cures Act into law. The legislation was introduced by Representative Fred Upton (R-MI) in July 2015 and was heavily revised before ultimately securing bipartisan support. The law is intended to advance biomedical research, streamline the approval process for drugs and medical devices, enhance mental health…

On November 22nd, HHS issued a proposed rule that would make changes to the Medicaid and CHIP Managed Care final rule published on May 6, 2016.  The final rule required states to start phasing out pass-through provider payments beginning July 1, 2017. Since the release of the final rule, some states have contacted CMS about…

On November 2nd, CMS issued a final rule that updates the Physician Fee Schedule (PFS) and other Medicare Part B payment policies for CY 2017. Provisions of the rule include: enrollment and data transparency updates to the Medicare Advantage program, modifications to the Medicare Shared Savings Program, and the expansion of the Diabetes Prevention Program…

On November 1st, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the CY 2017 Hospital OPPS and ASC Payment System. The final rule updates Medicare payment policies and rates for hospital outpatient departments and ambulatory surgery centers. The final rule includes modifications for site-neutral payments, the electronic health record incentive…

On October 31st, the CMS issued a final rule for the CY 2017 Medicare home health prospective payment system (HH PPS). The final rule will update the payment rates for home health agencies (HHAs) in 2017, add new measures to the Home Health Quality Reporting Program, and make changes to the Home Health Value-Based Purchasing…