Updates & Analysis

New York State has released an updated draft of the Delivery System Reform Incentive Payment (DSRIP) Value Based Payment (VBP) Roadmap (available here). The document outlines the State’s plan to make 80% of managed care Medicaid payments through VBP arrangements by the end of the DSRIP waiver period in 2020. The updated draft has been…

On March 8th, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would implement new Medicare Part B drug payment models and clinical decision support tools. The Center for Medicare and Medicaid Innovation would test the alternative payment models over a five-year period to assess the effect on beneficiary health outcomes…

One major focus of New York State’s Medicaid Redesign Team (MRT) reforms is allowing providers to offer integrated primary care and behavioral health services in community-based settings. However, in New York, each clinic site traditionally requires a separate license to offer a given type of service: an Article 28 license from the Department of Health…

On February 19th, the Centers for Medicare and Medicaid Services (CMS) released the 2017 Advance Notice and draft Call Letter, which propose payment and policy updates for Medicare Advantage (MA) and Medicare Part D prescription drug plans. CMS will be accepting comments through March 4th. Attached please find a summary of this information. The final…

On February 9th, President Barack Obama released his FY 2017 Budget proposal. The document sets forth recommendations for federal spending in the coming year, but has no force of law. The $4.1 trillion Budget is projected to reduce the deficit by $2.9 trillion, including $375 billion in health care savings, over the next ten years.…

As you know, the DSRIP program now has multiple funding streams flowing to providers. In addition to a PPS’s net project valuation, providers can also potentially receive money from the Equity Infrastructure Program, the Equity Performance Program, the High Performance Pool, the Additional High Performance Pool, and the Value-Based Payment Quality Improvement Program. In an…

On January 28th, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would refine the methodologies used for resetting benchmarks for accountable care organizations (ACOs) that continue to participate in the Medicare Shared Savings Program (MSSP) after their initial agreement period. CMS will accept comments until March 28th. This document summarizes…

On January 27th, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on the Medicaid program’s face-to-face requirements for home health services and medical equipment. The rule does not apply to Medicaid managed care.  The attached document summarizes several major provisions of the final rule. The provisions will become effective on July…

On January 5th, the Centers for Medicare and Medicaid Services (CMS) announced $157 million in funding for a new Center for Medicare and Medicaid Innovation (CMMI) initiative, the Accountable Health Communities (AHC) Model. The five-year grant program will allow up to 44 award recipients to test approaches for identifying and addressing the unmet health-related social…

The Dormitory Authority of the State of New York (DASNY) has released an amended Request for Applications (RFA), available here, and a Q&A document, available here, for the Nonprofit Infrastructure Capital Investment Program (NICIP). Some important amendments include the following provisions:  Applications are now due January 29, 2016. Additional questions on amended provisions may be…

On December 4th, the New York State Office of Mental Health, Office of Alcoholism and Substance Abuse, and Department of Health released an application to become designated as a Certified Community Behavioral Health Clinic (CCBHCs). This application is part of a one-year planning grant awarded to New York State by the Substance Abuse and Mental…

The New York Office of Mental Health (OMH) has released a Request for Proposals (RFP), available here, for a Non-Profit Behavioral Health and Developmental Disability Providers Health Information Technology (BH-DD HIT) program. The BH-DD HIT program will provide $10 million in one-time funding to help providers acquire technology systems and for other infrastructure costs associated…