Another Meeting on the NHTD/TBI Transition to Managed Care

Last week, LeadingAge NY participated in the Department of Health’s (DOH) stakeholder workgroup meeting on Phase II of the transition of the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Medicaid waiver plan into managed care. The agenda for this meeting included:

1. Introduction;
2. Transition Update: Jason A. Helgerson, Medicaid Director, Office of Health Insurance Programs;
3. Training Curricula: Audience and Content;
4. Updates;
5. Review Frequently Asked Questions (FAQs);
6. Open Discussion – Questions & Comments; and
7. Next Steps.

Several agenda items were not covered, such as the FAQs. Jason Helgerson reported on several pending federal issues as a result of the new administration. The issues he highlighted were the outstanding 103 State Plan Amendments (SPAs), technical waiver amendments, NHTD/TBI waiver renewals scheduled for February and March, and the status of the Affordable Care Act and its impact on the Community First Choice Option. Helgerson shared that many states are in limbo, and that we will wait and see the direction of the new administration. He expects that the CMS regional offices will reach out to the health departments and request a list of issues that are top priorities that need to be expedited. He reassured the stakeholders and the NHTD/TBI parents in attendance that the waiver renewals are a priority. This lead to another discussion of the numerous outstanding issues that need to be resolved prior to the transition into managed care. DOH again asked for the outstanding issues. We will re-submit our outstanding issues that need to be resolved prior to the transition to managed care.

DOH stated that they will continue to move forward with the NHTD/TBI transition plan as items are addressed on the federal level. To that end, DOH did ask for stakeholders to consider joining five training workgroups that will be charged with developing material for the transition of the waivers into managed care. The workgroups will develop the content and decide on the methodology for proving training to participants/families, waiver service providers, managed care plans, Maximus, and UAS-NY assessors.

The UAS-NY has been an ongoing concern for those participants needing to score a Level of Care of five or above. DOH informed the group that the audit report from IPRO should be available in February, the same with the national Inter-RAI report. Helgerson stated that he would support the finding from the reports and implement the recommended changes to the UAS-NY.

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