February 12, 2013
FREE audio conference on CMAS
On Friday, Jan. 18 LeadingAge NY will be conducting a free audio conference for long term care providers and plans interested in contracting to provide care management services. LeadingAge NY was instrumental in developing the revised Care Management Administrative Services (CMAS) contract agreement. As a result of our ongoing advocacy with DOH, the CMAS agreement allows providers to continue to perform care management services. Please join us as we discuss this new opportunity for providers and plans to contract for care management services. Click here for more information.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871
Advocacy Day is on Tuesday, Feb. 5!
The New York State Legislature has a lot of new faces this year, and their first order of business will be passing a balanced budget in the face of a $1 billion deficit. What impact will budget cuts have on your organization? Join us on Feb. 5 to meet with the newly elected legislators and reconnect with incumbent legislators to educate them about the important work you are doing and the daily challenges you face. Make sure they hear from you before passing bills that affect your industry and your mission. Register NOW!
Fiscal cliff legislation and important Medicare changes for 2013
LeadingAge NY provided members with a comprehensive analysis of Medicare changes arising out of the fiscal cliff legislation and other important Medicare developments for 2013. For complete details, please click here.
Avoiding E-Prescribing Penalties - audio conference
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827
LeadingAge announces Innovations Fund awards
LeadingAge awarded four organizations $25,000 each in the first-round of their Innovations Fund grants, including Charles M. Morris Nursing and Rehab Center at Weinberg Village in Pittsburgh, PA; Francis E. Parker Memorial Home in Piscataway, NJ; Jewish Community Housing for the Elderly in Brighton, MA; and Sayre Christian Village in Lexington, KY. In all, more than 125 applications were submitted for the inaugural LeadingAge Innovations Fund, which seeks to catalyze innovation among nonprofit providers of aging services by awarding grants for programs that promise to have a demonstrable impact on residents, clients, families, employees or the broader community. The first-year grants were given to projects that focused on the importance of bringing housing and services together to allow lower-income elderly to safely age in place.
Contact: Ken Harris, kharris@leadingageny.org, 518-867-8383, ext. 139
LeadingAge New York advocates for senior supportive housing
The Medicaid Redesign Team (MRT) Affordable Housing Work Group met on Thursday, Jan. 10, 2013 to discuss the recommendations stemming from the three sub groups that have been meeting over the past month. LeadingAge NY participated in all three groups and has been advocating for this year’s available budget funds to invest in affordable housing and services for seniors. Sub group reports were provided on “Program Model & Development,” “Funding” and “Planning/Service Coordination,” and included discussion on funding for affordable senior housing and services. The meeting presentation is posted to the work group's website. The sub groups will continue to refine recommendations, and the Affordable Housing Work Group will meet next on Feb. 22, and then sometime in March. LeadingAge NY will continue to work to ensure that funding is allocated to affordable senior housing with services.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, or Ken Harris at kharris@leadingageny.org, 518-867-8383
Governor proposes $1 billion for affordable housing
During the State of the State, Governor Cuomo proposed that New York invest $1 billion to preserve and create more than 14,000 affordable housing units statewide. The source of the $1 billion, according to the speech, will be through “reallocating and making better use of existing funds.” In addition, the Governor also outlined a plan to create or preserve approximately 5,600 units by investing in the “most successful affordable housing programs” and creating new programs to meet unfilled needs. No specific spending amount was identified for this latter proposal. In his address, Governor Cuomo called affordable housing “a terrible need,” and said the state is going to “step in big time to produce and preserve 14,000 units over five years.” The governor also announced plans to transfer the Mitchell-Lama asset portfolio of affordable housing loans to the NYS Home and Community Renewal (HCR) program to refinance these projects and leverage additional funding to rehabilitate and update 8,700 units.
Contact: Ken Harris, kharris@leadingageny.org, 518-867-8383, ext. 139
Say what? HUD Acronymania
If the statement: “HUD HQ requires the COAMs to review PRAC REAC submissions for PBCA ACC bids” leaves you wanting more, than you may be able to use the HUD Acronymania resource. The document spells out 11 pages of HUD acronyms in specific categories. It’s a must-read for new and seasoned housing professionals that are interested in trying to understand the variety of HUD and HUD-related programs. To view the HUD Acronymania, click here.
Contact: Ken Harris, kharris@leadingageny.org, 518-867-8383, ext. 139
DOH posts initial 2013 LTHHCP rates
DOH posted a Dear Administrator Letter (DAL) in the Health Commerce System (HCS) detailing the Long Term Home Health Care Program (LTHHCP) 2013 initial rates. Please log into your HCS account to see your initial 2013 Medicaid rate computation sheet for the period beginning Jan. 1, 2013. The DAL states that the initial rates are all-inclusive and based on the lower of 2011 allowable costs (held to regional ceilings) projected to the 2013 rate period as reported in your 2011 cost report, and it also outlines the appeal process.
Some of the additional LTHHCP issues outlined include:
- A zero percent trend factor as per the 2012-13 budget;
- Statewide average cap on administrative and general costs of 23.41 percent;
- A worker recruitment and retention adjustment of an increase of three percent for those providers who submitted their attestations; and
- An additional 4.7 percent rate add-on for the recruitment, training and retention adjustment proportionally adjusted based on total annual hours of service to Medicaid patients.
The hotline appeals process will be in effect until Feb. 15, 2013. According to the DAL, providers may phone the Bureau of the Long Term Care Reimbursement (BLTCR) with inquiries as to the accuracy of the rates. However, to effect a change in your rate through the accelerated administrative process, you must submit your written appeal to the Bureau, postmarked no later than Feb. 15, 2013.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871
Revised draft CHHA audit protocols
Last week LeadingAge New York and other associations met with staff from the Office of the Medicaid Inspector General (OMIG) to discuss our concerns with the draft Certified Home Health Agency (CHHA) audit protocols. As a result of the meeting, we received a revised version of the protocols on Jan. 11 and were requested to comment on them by Jan. 16. During the meeting, OMIG clarified that the protocols will apply to claims through Dec. 31, 2010.
Some of the issues raised during the meeting included the role of DOH surveillance and OMIG, accounting for spend-down, sampling and extrapolation, and denial of claims for missing pieces in a personnel file.
We have requested to be part of a work group to discuss audit protocols as the DOH moves from a fee-for-service system to managed care, and will keep members apprised of the developments.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871
MLTC consumer guides provide information about plan services and providers
DOH has posted 2012 Managed Long Term Care Regional Consumer Guides to the NYS DOH website for Long Island, Westchester and New York City regions. The guides were developed to assist consumers in choosing a managed long term care plan. Included on the site is data on consumer ratings on the plans, services the plans provide and what providers participate in the plan. The guides can be accessed by clicking here. These guides may be a resource to members and the people you serve.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828
OMIG poised to begin MDS audits
DOH and the OMIG have finalized a framework for MDS audits and OMIG is preparing to perform audits at four facilities in the Albany area. Consistent with our strong advocacy, extrapolation will not be used. Instead, OMIG will audit all “high risk” MDS records. “High risk” is defined as an MDS record of a resident whose RUG assignment would change if one or two errors were found and corrected. If an error is found that would affect the resident’s RUG assignment, the correct RUG would be assigned and the home’s Case Mix Index (CMI) recalculated.
All 304 homes whose CMI increased by more than five percent will have an audit of their “high risk” MDS assessments associated with their January 2012 roster submission: The first 90 homes by mid-March (at which time DOH will make a determination about releasing the balance of the rate adjustment for case mix), and the remaining 214 homes by July 2013.
DOH intends to consult with Myers and Stauffer, a firm with extensive MDS auditing experience in other states, to fine tune the audits and will solicit proposals from outside contractors to perform these audits in the future. Click here to read more.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
Nursing home Medicaid rates posted
DOH posted January 2013 initial Medicaid rate sheets for nursing homes to the Health Commerce System (HCS) on Friday, Jan. 11. The case mix used in these rates is the same as in the initial 7/1/12 rates (i.e., January 2012 roster-based CMI constrained to a five percent change). While the 2013 statewide base price is higher than in 2012, homes whose rates are impacted by stop-loss factors will see a rate decrease as the stop loss percentage increases from 1.75 to 2.5 percent.
The 2013 capital calculation is not yet available for hospital-based nursing homes that file the RHCF-2 cost report; so for these homes the 2012 capital is reflected in these rates. Adult Day Health Care rates are not yet processed. DOH is making 2013 capital corrections based on feedback from programs with the hope of finalizing the rates by April.
DOH did not make negative rate adjustments for the period 7/1/12 through 12/31/12 for homes located in Hurricane Sandy impacted areas. Rate adjustments effective 1/1/13 are being made for these homes and their 1/1/13 rate sheets are posted. Adjustments for the 7/1/12 through 12/31/12 period will be made at some future date.
DOH has sent the 1/1/13 rates to e-MedNY and they should be reflected in checks dated Jan. 21 with a release date of Feb. 6.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
Registration is now open for the LeadingAge PEAK Leadership Summit in Washington, DC.
This executive-level conference is a dynamic educational experience designed exclusively for strategic leaders in aging services. With keynotes from former senator Olympia Snowe and successful CEO Peter Sheahan PEAK offers insights and strategies to help your team address current organizational challenges and prepare for the future.
Join us March 18 – 20 and hear from innovative leaders who are developing strategic initiatives to respond to evolving service lines and changing consumer preferences.
For more information or to register, visit LeadingAge.org/PEAK.