Home and Community-Based Care Workgroup Update

The members of the Home and Community-Based Care Workgroup on regulatory relief and reform submitted their recommendations to DOH Commissioner Shah on Feb. 27th. As you may recall, this workgroup was established as a result of language in the 2013-14 state budget agreement. The workgroup submitted seven recommendations before the due date of March 1st.  In their letter they also included the September 2013 list of joint home care regulatory reform and priorities from the three associations: LeadingAge NY, Home Care Association of NYS and the NYS Association of Health Care Providers.

The issues and recommendations are outlined in a letter to the Commissioner, which include suggestions to:

• Continue with the workgroup for another year, with further recommendation due in September 2014 and February 2015;
• Develop a listing of roles and responsibilities within the managed care construct to clarify functions and roles by provider type;
• Develop uniform billing codes, timeframes for authorizations, payment assurances and steps towards electronic payment;
• Follow-up on the other recommendations presented by the three associations that are not included in these seven recommendations;
• Adopt amended Title X Part 425 adult day health care regulations on an expedited basis;
• Engage hospice stakeholders in the development process of the Fully Integrated Dual Advantage (FIDA) program; and,
• Not unbundle hospice services; rather, Managed Care Organizations offer hospice services as defined under Article 40 of the Public Health Law.  Pay nursing homes directly for the Medicaid nursing home room and board.

LeadingAge NY appreciates all the time and effort of the workgroup in developing the final recommendations to the Commissioner.

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