State Postpones Launch of Nursing Home Managed Care

Late last week, the Department of Health (DOH) announced that the proposed launch date for the transition of nursing home services to Medicaid managed care in the Fully Integrated Duals Advantage (FIDA) region (NYC, Long Island and Westchester) has been postponed to Aug. 1, 2014. The announcement comes as the Centers for Medicare and Medicaid Services (CMS) continues to review the State’s proposal and has yet to render its approval.  Meanwhile, LeadingAge NY and its association colleagues continue to seek clarity and make recommendations on several unresolved issues with the transition.

LeadingAge NY and other associations recently met with DOH officials to discuss our document detailing a series of unresolved issues relative to the transition of the nursing home benefit and population into Medicaid managed care. The issues fall into four major categories: (1) cash flow; (2) other payment areas; (3) enrollment/eligibility/coverage; and (4) network/contracting. DOH responded in writing to our questions and recommendations, to which we reacted. During the meeting, we began going through these issues, and DOH indicated there would be additional responses forthcoming.

In response to our concerns about cash flow, DOH plans to convene a work group on billing and related issues. LeadingAge NY will be represented on the group, as will other provider and managed care plan associations.

In an effort to further assist its members, LeadingAge NY is currently working on a Frequently Asked Questions document about the nursing home managed care transition. Please continue to forward any questions you have to us in the meantime.

Contact: Dan Heim; dheim@leadingageny.org; 518-867-8866