FIDA and MLTC Update Highlights

Fully Integrated Duals Advantage (FIDA) and Managed Long Term Care (MLTC) Update Mark Kissinger, Director, Division of Long Term Care Margaret Willard, Director, Bureau of MLTC Shanon Vollmer, FIDA Project Director Division of Long Term Care Office of Health Insurance Programs New York State Department of Health (DOH) Managed Care Policy and Planning Meeting April 23, 2015

2 FIDA Enrollment Update* NY Medicaid Choice Calls Received April 1 Enrollment Total Opt-Outs 70,911 41,906 4,158 *As of April 18, 2015 ^ 4,158 individuals were enrolled in FIDA on April 1. Between 4/1 and 4/18, 1,101 have disenrolled for 5/1.

3 Upcoming Passive Enrollments May 1 The 90-day, the 60-day, and 30-day notices were released. 3,733 individuals as of April 18, 2015. June 1 No Passive Enrollment scheduled, pushed to July 1, 2015. July 1 No 90-day notice will be sent. Updated 60-day notices will be sent. 5,498 individuals as of April 18, 2015.

4 FIDA Update Marketing The New York State Marketing Guidance was updated and released to Plans. Will release permissible activities chart to Plans this week. A MLTC/FIDA comparison chart for Plans to share with current or potential participants that explains the benefits of FIDA is targeted for release this month. Interdisciplinary Team (IDT) Stakeholders including advocates and plans provided suggestions to improve upon existing policy. DOH and the Centers for Medicare and Medicaid Services (CMS) are making DRAFT revisions and will release for discussion.

5 FIDA Update Provider Training: As of April 14, 2015, more than 9,200 Providers have registered for the core Provider training module on the Lewin portal. Additional Modules: Two new modules (Behavioral Health and Cultural Competency) have been added to the portal. A new letter will be sent by Plans letting them know that the new modules are available. Two additional training modules are in development supplementary IDT and Americans with Disabilities Act compliance training. A Frequently Asked Questions (FAQ) document on provider training and instructions were released to Plans to be shared with providers: https://www.resourcesforintegratedcare.com/sites/default/files/Provider%20Training%2 0Q%20%20A_3_30_2015_1.pdf Rates: DOH is working with CMS on revising the FIDA rates.

6 FIDA Update The final instructions on Encounter Data were released. DOH presented to the Adult Day Health Care Council, New York State Adult Day Services Association, and the Regional Resource Development Centers of Long Island. DOH released a provider mailing and FAQ for in-network Medicaid Providers. DOH has developed a Participant friendly website: https://www.health.ny.gov/health_care/medicaid/redesign/fida/

7 MLTC Update Statewide Enrollees in MLTC as of April 1, 2015: New York City: 113,456 Rest of state: 21,572 Total: 135,028

8 MLTC Upstate Transition Purple = counties that are not yet mandatory MLTC. Gray = counties that are mandatory.

9 MLTC Update Since the last Policy and Planning meeting, the following has occurred: The Medicaid Redesign Team (MRT) 90 websitehas been updated to include: The Revised Conflict-Free Evaluation and Enrollment Center (CFEEC) Implementation Timeline. The timeline was revised to reflect that all upstate counties have not made the transition to mandatory MLTC, A new CFEEC FAQ, and A Quality Incentive/Vital Access Provider Pool (QIVAPP) Program FAQ and webinar. (https://www.health.ny.gov/health_care/medicaid/redesign/mrt_90.htm)

10 CFEEC Revised Implementation Timeline Region/Month Counties Region 1 October 2014 Region 2 November 2014 Region 3 February 2015 Bronx and New York Kings, Nassau, Queens, and Richmond Suffolk and Westchester East Hudson (Columbia, Dutchess, and Putnam) Catskill (Greene, Orange, Rockland, Sullivan, and Ulster) Capital (Albany, Fulton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington) Other (Erie, Monroe, and Onondaga) Region 4 March 2015 Southern Tier (Broome, Chenango, Cortland, Delaware, Otsego, Tioga, and Tompkins) Finger Lakes (Cayuga, Livingston, Ontario, Steuben, and Wayne) Western (Cattaraugus, Genesee, Niagara, Orleans, and Wyoming) Region 5 April 2015 Region 6 May 2015 Central (Herkimer, Madison, Oneida, and Oswego) Northern (Clinton, Essex, Franklin, Hamilton, and St. Lawrence) Finger Lakes (Chemung, Schuyler, Seneca, and Yates) Central (Jefferson and Lewis) Western (Allegany and Chautauqua) Region 7 June 2015

11 CFEEC Activity as of April 1, 2015 The CFEEC is operational in Regions 1 through 5. Letters were sent to each Local Department of Social Services (LDSS) commissioner in Region 5, explaining the change. Nurse trainings were completed in these counties. Average volume is 627 to 656 calls per day. 144 nurses are on staff to handle the volume. Evaluations conducted to date: 99% approval rate 1% denial rate