New York’s Managed Long Term Care Waiver Amendment Approved by CMS

Sept. 12, 2012 - PRLog -- Albany, NY (9/5/2012) - The Center for Medicare and Medicaid (CMS) has approved New York State’s Managed Long Term Care Waiver Amendment, but the verdict is still out on the MRT reinvestment waiver itself.

CMS approved the waiver amendment in a letter to Dr. Nirav Shah, Commissioner, New York Department of Health (NYSDOH) on September 5. The award is a partial response to an April 13, 2011, request from NYSDOH to CMS.

With the letter, the NYSDOH received approval from CMS to require certain Medicaid consumers to enroll in managed long term care plans. Consumers with Medicare coverage, over 21 years of age and in need of more than 120 days of home and community based long term care services will be enrolled in a managed long term care plan over the next several years.

This approval represents significant progress for the Medicaid Redesign Team's vision of care management for all. The NYSDOH has partnered with stakeholders, local social services districts, and New York Medicaid Choice to launch the mandatory program first in New York City and will continue implementation statewide.

The NYSDOH will continue to have bi-weekly implementation calls, provide education and outreach to stakeholder communities in NYC and will engage with local social services districts in advance of the transition to mandatory managed long term care.

For additional information: http://www.health.ny.gov/health_care/medicaid/redesign/11...

Below are excerpts from the CMS approval Letter (bullets added):

This letter is to inform you that the Centers for Medicare & Medicaid Services (CMS) is granting your request to amend New York's Medicaid section 1115 Demonstrations, entitled "Partnership Plan" (11-W-00114/2), and "Federal-State Health Reform Partnership (F-SHRP)" (11-W-00234/2). We are approving the amendment to the Demonstrations under the authority of section 1115(a) of the Social Security Act, and the amendment is effective from the date of this letter through the end of the Demonstrations.

This award is a partial response to the letter sent April 13, 2011, by Mr. Jason Helgerson, in which Mr. Helgerson requested several changes to the Partnership Plan and F–SHRP Demonstrations. At this time, CMS is approving the state's request to establish the managed long-term care (ML TC) program under the Demonstrations, which will:

•   expand mandatory Medicaid managed care enrollment to dually-eligible individuals over age 21 who receive community-based long-term care services in excess of 120 days and
•   provide dually-eligible individuals age 18 - 21, as well as nursing home eligible non-dual individuals age 18 and older, the option to enroll in the MLTC program.
•   In addition, this amendment permits the state to expand eligibility to ensure continuity of care for individuals who are moving from an institutional long-term care setting to receive community-based long term care services through the managed long-term care program.

The MRT reinvestment waiver request (http://www.health.ny.gov/health_care/medicaid/redesign/do...) was submitted to CMS on August 6, 2012. View the NYS MRT Waiver Amendment Request - Document (PDF, 4.4MB, 152pgs.)

For more information, go to http://www.health.ny.gov/health_care/medicaid/redesign/ or email mltcworkgroup@health.state.ny.us.

About NYSAAAA

The New York State Association of Area Agencies on Aging represents the state’s local offices for the aging established under the federal Older Americans Act to respond to the needs of Americans age 60 and over. The Association provides professional development and education that includes the annual Aging Concerns Unite Us (ACUU) conference, webinars, regional caregiver forums and a fall Leadership Institute. The Association works to strengthen and expand long term services and supports to individuals so they may age in place in the community.  A core philosophy is to work in collaboration with other agencies, which is accomplished through the Aging Alliance, a coalition of organizations representing Older New Yorkers. Looking to the future, the Board of Directors has approved a new name, the Association on Aging in New York, to create a more cohesive and inclusive network to address the diverse needs of an aging population, as well as individuals of all ages needing long term services and supports. For more information, go to http://www.nysaaaa.org The new web site will soon be operational at www.agingny.org