Governor Cuomo Announces Over $50 Million in Funding for Home Health Services for Senior Citizens Not Yet Eligible for Medicaid

Today, New York Governor Andrew Cuomo announced that $50 million in funding from the state’s Expanded In-Home Services for the Elderly Program has been awarded to the state’s county-based Area Agencies on Aging for the purpose of helping New York’s senior citizens to obtain home health care services.  The press release states that the funding “will […]

New York State Comptroller Audits Social Adult Day Programs

New York State Comptroller Thomas DiNapoli today released an audit of Social Adult Day Services (“SADS”) programs in New York State.  The audit is available here.  Among other recommendations, the Comptroller asks the New York State Department of Health and New York State Office for the Aging to consider more closely regulating these programs.

CMS Issues 2015 Managed Care Rate Setting Consultation Guide

On Wednesday, October 2, the Centers for Medicare and Medicaid Services (“CMS”) issued its  2015 consultation guide for states to use when setting reimbursement rates with respect to any Medicaid managed care program subject to actuarial soundness requirements in 42 CFR 438.6 during rating periods starting January 1, 2015.  The guide “describes information that CMS expects states to provide […]

Who’s Looking Out for Patients? OIG Recommends more CMS Oversight of Medicaid Managed Care Programs

Office of the Inspector General of the federal Department of Health and Human Services (“OIG”) has issued a report that suggests that most states that offer Medicaid through Managed Care Organizations (“MCOs”) have widely-variable and possibly inadequate oversight of the organizations providing care to Medicaid beneficiaries.  Given OIG’s findings, beneficiaries, providers, and Medicaid MCOs should […]

Jason Helgerson Makes MLTC Encounter Data a Priority

At a Managed Care Policy Meeting held last week with managed care plans, New York’s Medicaid Director, Jason Helgerson, spoke about the importance for plans to submit timely and accurate encounter data.  He noted that managed long term care plan submissions are particularly late.  He indicated that if the lack of reporting continues there is […]

Medicaid Director Announces House Oversight Committee Interest in Managed Long Term Care

On June 20, 2013, at the Managed Care Policy Meeting, Jason Helgerson announced that the House Oversight Committee has asked CMS to investigate managed long term care plans related to the use and possible abuse of social day care programs in New York City.  Mr. Helgerson reminded Plans that enrollment from Social Day Care Programs […]

New York Managed Long Term Care Enrollment Hits 100,000

At its recent meeting on June 13, 2013, the N.Y.S. Department of Health Medicaid Managed Care Advisory Review Panel (MMCARP) was updated about enrollment in Managed Long Term Care.  DOH staff announced that enrollment across the state in 3 types of managed long term care plans has crested the 100,000 mark.  The partial caps, PACE […]