NYS Files with CMS Its Final Proposal to Manage Care for All Dual Eligibles - Consumer Comments Filed June 30th

The State DOH filed its final proposal for a Fully Integrated Dual Eligible (FIDA) managed care plan with the federal government  on May 25, 2012.

• FINAL Demonstration Proposal to Integrate Care for Dual Eligible Individuals 
  
• Click here for COMMENTS  filed by consumer organizations on June 30th, 2012. 
  

The State filed this final proposal on May 25th, one week after receiving comments by consumer advocates and other stakeholders on its previous draft  on May 17, 2012.  These consumer advocate comments filed by Medicare Rights Center, the Center for Disability Rights, Center for Independence of the Disabled NY, Community Services Society of NY,  Empire Justice Center, Legal Aid Society, New York Association on Independent Living, and Selfhelp Community Services, Inc.  are posted here.  The comments raise many concerns about the "passive enrollment" model, in which individuals will be automatically assigned to a plan with the right to opt-out.   Other concerns are voiced about adequacy of the plan's networks of providers -- will people with chronic health conditions have access to specialists they need?  Also discussed are oversight and accountability, grievance and hearing rights, contracting requirements and payment models to incentivize adequate care, and compliance with the Americans with Disabilities Act.

• The  State's earlier draft of its FIDA plan is posted here. 

• This revised proposal was posted less than 2 weeks after the comment period deadline expired on the initial proposal -- April 20th.  Consumer advocates in NYS jointly filed comments on the initial proposal that expressed serious concerns about the New York State  proposal for a Fully-Integrated Dual Advantage (FIDA) plan.  As proposed, New York State would -- beginning in 2014 -- automatically enroll more than 460,000 dually eligible New Yorkers living in New York City, Long Island, and Westchester into newly created managed care insurance plans.  These plans would control access to ALL Medicare and Medicaid services, including primary care, inpatient care, and long-term care.

• Consumers' original comments on the first draft of the State's proposal are posted here.
  

For more information on the federal initiative to coordinate care for dual eligibles and the NYS response, see this article.