Nursing Home Transition and Diversion and Traumatic Brain Injury Waivers Updates

Transition Workgroup

LeadingAge New York is now serving on the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver transition workgroup. As a reminder, this follows the Department of Health (DOH) extending the effective date for both the NHTD and the TBI populations to transition to mandatory Medicaid managed care to Jan. 2017 (mainstream and managed long term care). Three meetings have been scheduled for the transition workgroup, with the first meeting held on Aug. 24. The DOH workgroup informational packet includes the following:

1.     MRT Action Plan excerpt

2.     Chapter 59 of the Laws of 2011 excerpt

3.     1115 Waiver Attachment G

4.     Workgroup Letter

5.     Overview of NHTD

6.     Overview of TBI

7.     TBI NHTD Service Comparison

8.     Overview of Managed Long Term Care (MLTC)

9.     Overview of Medicaid Managed Care (MMC)

NHTD Lawsuit

Four nursing home residents have filed a class-action suit last week against the NHTD Regional Resource Development Center (RRDC), Visiting Nurse Association of Staten Island, and DOH.

The lawsuit against the NHTD waiver program targets how it is designed and managed by the RRDC and overseen by DOH. The lawsuit alleges the RRDC routinely decided applicants were ineligible for the waiver without explanation, or were denied for incorrect reasons, or failed to inform applicants of their right to a fair hearing to appeal decisions. The complaint was filed by the nonprofit MFY Legal Services and law firm Patterson Belknap Webb & Tyler on behalf of plaintiffs.

TBI Audit Protocols Update

LeadingAge NY previously reported in July that the NYS Office of the Medicaid Inspector General (OMIG) posted the TBI audit protocols. We have since confirmed with OMIG that the service dates are prior to July 3, 2015.

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