State Applies for Balancing Program Funds - February 12, 2013

The DOH has just released its application to CMS to participate in the federal Balancing Incentive Payment (BIP) Program. This was first mentioned as MRT initiative #122. Under the Affordable Care Act (ACA), BIP states that expand the delivery of care via HCBS are eligible for a two percent increase in FMAP. In the Executive budget, $20 million was allocated for the BIP Program. In the application, New York estimates and requests that it will receive $645,504,803 million during this project funding period (1/1/13-9/30/2015).

Under BIP, states who are spending less than 50 percent of their long term care funding on non-institutional care can apply for enhanced federal monies to increase this proportion by implementing three structural changes. In its application, the state expresses its intention to implement the required structural changes, including creating a No Wrong Door/Single Entry Point system, a statewide core standardized assessment and a conflict-free case management system.

Nine other states have had their applications approved. At this time, it appears only New York has submitted an application that includes the transition to managed care and managed long term care as being consistent with the goals of BIP. In the BIP Implementation Manual, CMS clarifies they are "currently reviewing the options for conflict-free case management in a managed care environment, and will provide updated guidance to states when it has been developed."

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871