Important Dates from the Managed Care Policy and Planning Meeting
During the Thurs., Jan. 8 Managed Care Policy and Planning Meeting, the Department of Health (DOH) confirmed that Sun., Feb. 1, 2015 is the official date for beginning the transition of nursing home population and benefit into Medicaid managed care. As previously announced, the downstate transition of new permanent nursing home placements will now occur in two phases with the transition in New York City boroughs (Phase 1) commencing on Sun., Feb. 1, 2015. New permanent nursing home residents in Nassau, Suffolk and Westchester counties (Phase 2) will be required to enroll in a Medicaid Managed Care or Medicaid Managed Long Term Care Plan beginning on Wed., April 1, 2015. The rest of the State (Phase 3) will transition starting Wed., July 1, 2015.
Starting in October 2015, nursing home residents not mandated to join a managed care plan (i.e., those grandfathered into Medicaid fee-for-service as permanent nursing home residents prior to the transition date) will be able to do so voluntarily. DOH announced that they intend to host a webinar on the nursing home transition on Thurs., Jan. 22; LeadingAge NY will advise members as more details of the webinar are finalized.
DOH also announced some important dates regarding Delivery System Reform Incentive Payment Program (DSRIP) Performing Provider Systems (PPSs). The current 25 PPS applications will be posted for a 30-day public comment period on Wed., Jan. 14, 2015. The first mandatory PPS meeting will be held on Fri., Jan. 16, 2015 to provide the PPSs with the template for their implementation plans that are due in March. DOH is setting aside the dates of Tues., Feb. 17- Fri., Feb. 20 for the Oversight Panel to hold the first public hearings on the PPS plans allowing for modification of the subjective aspects of the PPS plans. DOH noted that all 25 PPSs met the minimum scoring requirements needed to proceed to the next phase of implementation. DOH anticipates starting monthly PPS meetings and eventually holding joint meetings between the PPSs and the managed care organizations. DOH is still looking at an April deadline for submitting their plan on the integration of DSRIP and managed care to the Centers for Medicare and Medicaid Services (CMS).
DOH extended the deadline for PPSs to submit Certificate of Public Advantage (COPA) applications to Sun., Feb. 1, 2015. They reported not receiving any applications, most likely due to the tight timeframe for the initial deadline. DOH anticipates final approval of COPA applications by Tues., June 30, 2015.
Fri., Jan. 23, 2015 is the date for the next meeting of the DOH value based purchasing work group. The goal is to develop a “roadmap to value based payment” for submission to CMS prior to April 1. DOH must meet this deadline in order to incorporate value based purchasing into the April 2015 managed care rate updates, which will require CMS approval. LeadingAge NY is representing our members on this work group.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827