New York

New York (NY) Capitated Financial Alignment Model Demonstrations:

NY Fully Integrated Duals Advantage - Intellectual and Developmental Disabilities (NY FIDA-IDD)

NY Integrated Appeals and Grievances Demonstration

NY Fully Integrated Duals Advantage (NY FIDA): *12/31/2019 - transitioned to NY Integrated Appeals and Grievances Demonstration*

 

SPOTLIGHT & RELEASES

 

Key Dates

November 5, 2015: CMS & NY sign MOU for FIDA-IDD model

January 14, 2016: CMS, NY & the participating plan execute three-way contract for FIDA-IDD model

April 1, 2016: Start of opt-in enrollment in New York, Long Island, Rockland & Westchester Counties for FIDA-IDD model

November 7, 2016: The NY FIDA-IDD model IDT policy is released

January 18, 2018: The NY FIDA-IDD model IDT policy is released

January 1, 2020: The NY Integrated Appeals and Grievances Demonstration begins

February 21, 2020: CMS & NY finalize MOU for Integrated Appeals and Grievances Demonstration

 

FIDA-IDD Demonstration

On November 5, 2015, CMS announced their partnership with the New York State Department of Health (NYSDOH) and the Office for People with Developmental Disabilities (OPWDD) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience. Approximately 20,000 Medicare-Medicaid IDD enrollees in the New York downstate region (New York City, Long Island, Rockland and Westchester Counties) will have an opportunity to receive more coordinated care as a result of this new program.

More Information from CMS:

Information for the Plan:

Information from the state of New York:

 

FIDA (*transitioned 12/31/2019*) and NY Integrated Appeals and Grievances Demonstration

On January 1, 2020, CMS and NYSDOH transitioned remaining FIDA enrollees to MAP plans and aligned D-SNPs. This transition also included extending the FIDA integrated appeals and grievances process to MAP and aligned D-SNP plans. Under the revamped NY Integrated Appeals and Grievances Demonstration, CMS and NYSDOH are testing the integrated appeals and grievances process begun under FIDA with a larger volume of full benefit dual eligible individuals. As of January 2020, approximately 18,000 individuals are enrolled in a MAP and aligned D-SNP plan.

More Information from CMS on NY Integrated Appeals and Grievances Demonstration:

More Information from CMS on NY FIDA Demonstration (*transitioned 12/31/2019*):

Information for Plans:

Information for Beneficiaries and Providers:

Information from the state of New York:

Funding Support:

Page Last Modified:
12/16/2020 02:50 PM