New York

New York (NY) Capitated Financial Alignment Model Demonstrations: NY Fully Integrated Duals Advantage (NY FIDA) & NY FIDA-Intellectual and Developmental Disabilities (NY FIDA-IDD)

SPOTLIGHT & RELEASES

On 1/1/2020, NY transitions FIDA model demonstration from MMPs to NY Medicaid Advantage Plus (MAP) and Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) program

10/30/2019 - New York FIDA 60-Day MAP Notice (PDF)

10/29/2019 - New York FIDA 30-Day D-SNP Notice (PDF)

10/01/2019 - New York FIDA MMP Non-Renewal & Service Area Reduction Guidance Memo (PDF) & Non-Renewal Notices (ZIP)

09/24/2019 - First Evaluation Report for the New York Fully Integrated Duals Advantage (FIDA) capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (09/24/2019) (PDF)

09/23/2019 - New York FIDA Phase-out Plan (PDF)

08/14/2019 - New York FIDA Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 3 (PDF) & New York FIDA-IDD Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 1 (PDF)

Key Dates

August 23, 2013 - The Centers for Medicare & Medicaid Services (CMS) and NY sign MOU for FIDA model

October 21, 2014 - CMS, NY and participating plans execute three-way contract for FIDA model

January 1, 2015 - Start of opt-in enrollment in Bronx, Kings, Nassau, New York, Queens, and Richmond Counties for FIDA model

April 1, 2015 - Start of passive enrollment in Bronx, Kings, Nassau, New York, Queens, and Richmond Counties for FIDA model

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

December 9, 2015 - CMS and NY release new flexibilities for the FIDA model, including a suspension on future passive enrollment. For more information, please visit the FIDA Capitated Duals Demonstration web site at this link: http://www.health.ny.gov/health_care/medicaid/redesign/mrt_101.htm

January 14, 2016 - CMS, NY and 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 and Westchester Counties for FIDA-IDD model

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

Early 2017 - Enrollment began in Suffolk and Westchester Counties for the FIDA model for one plan. Initially, enrollment was available in one plan - additional plans became available in Westchester County in the summer of 2017.

January 1, 2018 - CMS, NY and participating plans execute an amended three-way contract for the FIDA model

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

January 1, 2020 - The NY FIDA model demonstration transitions from MMPs to NY Medicaid Advantage Plus (MAP) and Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) program

FIDA Model (demonstration transitions 1/1/2020)

On August 26, 2013, CMS announced that the New York State Department of Health (NYSDOH) will partner with CMS to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.

Under the demonstration, also called Fully Integrated Duals Advantage (FIDA), New York and CMS will contract with health plans to coordinate the delivery of and be accountable for all covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees. As of December 2014, approximately 78,000 individuals were eligible for passive enrollment into the FIDA Demonstration.

More Information from CMS:

Information for Plans:

Information for Beneficiaries and Providers:

Information from the state of New York:

Funding Support:

FIDA-IDD Model

On November 5, 2015, CMS announced their partnership with 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:

Page Last Modified:
10/30/2019 06:43 PM