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March NHTD/TBI Stakeholders Meeting

The Department of Health (DOH) held another stakeholders meeting on the Nursing Home Transition & Diversion (NHTD)/Traumatic Brain Injury (TBI) Medicaid waivers transition into managed care. The agenda included two items: discussion of training and a review of outstanding issues outlined by the Alliance. DOH stated that the workgroup would develop the content, methodology, and material for the training components. It was suggested that the material developed for the Fully Integrated Duals Advantage (FIDA) plans be considered as a training resource. DOH stated that FIDA plans are already providing some of the waiver services to their dually-eligible participants. They also confirmed that the transition timeline was adjusted again. Community First Choice Option (CFCO) will be implemented in January 2018, and the waivers transition date has been moved to April 2018.

The next agenda item covered outstanding issues with the transition plan. DOH read a document that responded to stakeholders’ outstanding issues and concerns. As part of this discussion, DOH stated that they are finalizing its audit of the Uniform Assessment System for New York (UAS-NY) to further address issues with the tool’s ability to identify cognitive impairments. The findings from the IPRO audit and the national workgroup will be discussed at the next workgroup meeting. DOH stated that they are committed to applying the recommendations from the report and audit.

DOH shared that the “black-out” period with the staff at the Centers for Medicare & Medicaid Services (CMS) has been lifted, and they are back having calls with CMS on the waiver extensions. Some of the issues that are being discussed are the re-calculations in Appendix J for rates, rate methodology, and cost reporting; new abridged cost reports for the extensions; and conflict of interest with Service Coordination.

As a reminder, the TBI waiver is set to expire this month, and the NHTD waiver will expire in May. DOH remains optimistic that CMS will approve the waiver extensions.

After the meeting, DOH posted several updated documents:

DOH will be notifying stakeholders of the April date for the next meeting. As a reminder, this meeting will cover the findings of the UAS-NY audits and recommendations. LeadingAge NY will keep members posted on any new developments.

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