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

03/13/2020: CMS released revised information on the NY FIDA, NY FIDA-IDD, & NY Integrated Appeals and Grievances, Demonstrations including the MOU, Evidence of Coverage, MAP Handbook, CY 2020 ANOC, and Integrated Beneficiary Notices for the NY Integrated Appeals and Grievances Demonstration

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:
05/18/2020 07:41 AM