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Medicaid Redesign Team: Managed Long Term Care Implementation and Waiver Redesign Work Group

Contact the MRT Managed Long Term Care Implementation and Waiver Redesign Work Group

Share your thoughts with the MRT Managed Long Term Care Implementation and Waiver Redesign Work Group by emailing mltcworkgroup@health.state.ny.us.

Draft Enrollment Plan - Mandatory Managed Long Term Care/Care Coordination Model

Care Coordination Model (CCM) Guidelines, Application, and Webinar

Care Coordination Model (CCM) guidelines pursuant to Section 4403-f (7) (b) of the Public Health Law. The guidelines provide guidance for implementing the Care Coordination Model Principles that were developed as part of the Medicaid Redesign Team's Managed Long Term Care Implementation and Waiver Redesign Workgroup.

Questions about the CCM guidelines should be sent to the following email address: mltcworkgroup@health.state.ny.us.

Managed Long Term Care Model Contracts

  • This is the Model Contract that has been approved by Centers for Medicare and Medicaid Services (CMS) for a Managed Long Term Care (MLTC) Partial Capitation plan. The Model covers the period 1/1/12 to 12/31/14, with opportunity for one additional two year period or two additional one year periods.
  • This is the Model Contract that has been approved by the Centers for Medicare and Medicaid Services (CMS) for a Medicaid Advantage Plus (MAP) plan. The Model covers the period 1/1/12 to 12/31/14, with opportunity for one additional two year period or two additional one year periods.
  • This is the Model Contract for the Program of All-Inclusive Care for the Elderly (PACE) plan. The Model covers the period 1/1/12 to 12/31/14, with an opportunity for one additional two year period or two additional one year periods.
  • This is the Model Contract that has been approved by the Centers for Medicare and Medicaid Services (CMS) for the Medicaid Advantage plan. The Model covers the period 1/1/2011 to 12/31/13, with an opportunity for one additional two year period or two additional one year periods.

Solicitation for Public Comment: NYSDOH Demonstration Proposal to Integrate Care for Dual Eligible Individuals

Overview of New York's Demonstration to Integrate and Manage Care for Individuals Eligible for Medicaid and Medicare

Work Group Recommendations

Work Group Mission

  • Advise DOH on the development of care coordination models (which may include Long Term Home Health Care Programs) to be used in the mandatory enrollment of persons in need of community-based long term care services.
  • Review processes to ensure that sufficient patient protections exist and will promulgate guidelines for network development, to assure that the contractual arrangements for benefit package services are sufficient to ensure the availability, accessibility and continuity of services.
  • Discuss ways to promote access to services and supports in homes and communities, so individuals may avoid nursing home placement and hospital stays.

Work Group Members

The members of the Managed Long Term Care Implementation and Waiver Redesign work group were selected by co-chairs and MRT members Eli Feldman and Carol Raphael.

Co-chair: Eli Feldman, President & CEO,Metropolitan Jewish Health System and Chairman, Continuing Care Leadership Coalition

Co-chair: Carol Raphael, President & CEO, Visiting Nurse Service of New York

  • Michael Birnbaum, Vice President, United Hospital Fund
  • Courtney Burke, Commissioner, Office of People with Developmental Disabilities
  • Jo-Ann A. Costantino, Chief Executive Officer, The Eddy
  • Doug Goggin-Callahan, NYS Policy Director, Medicare Rights Center
  • George Gresham, President, 1199-SEIU
  • Mary Harper, Executive Deputy Commissioner, Medical Insurance & Community Services Administration, New York City Human Resources Administration
  • Joseph M. Healy, Jr. PhD, Chief Executive Officer, Comprehensive Care Management Corp.
  • Tom Holt, President & CEO, Lutheran Social Services
  • Mark Lane, President & CEO, New York State Catholic Health Plan, Inc., Fidelis Care New York
  • David McNally, New York Manager of Government Relations and Advocacy, AARP
  • Alan R. Morse, JD, PhD, President & CEO, The Jewish Guild for the Blind, GuildNet, Inc.
  • Betty Mullin-DiProsa, President & CEO, St. Ann's Community
  • Carol Rodat, New York Policy Director, PHI
  • M. Kate Rolf, President and CEO, VNA of Syracuse
  • Marilyn Saviola, Director of Advocacy, Independence Care System
  • Melanie Shaw, JD, Executive Director, New York Association on Independent Living (NYAIL)
  • Kathleen Shure,Senior Vice President, Managed Care & Insurance Expansion, Greater New York Hospital Association

Work Group Meetings

PLEASE NOTE:Space for meeting observers is EXTREMELY limited (first 20-25 people only – others will be turned away). Bring picture ID for access to all buildings.

A conference call phone number to dial in to listen (only) to these meetings will be posted to the MRT Web site at least one day in advance of each meeting.

Friday, July 8, 2011, 10:00am to 4:00pm

  • NYC - NYS Department of Health Metropolitan Area Regional Office
  • 90 Church Street, 4thFloor Conference Room A/B, Manhattan
  • Minutes from July 8 Managed Long Term Care Implementation and Waiver Redesign Work Group meeting
  • Recorded Conference Call from July 8 Managed Long Term Care Implementation and Waiver Redesign Work Group meeting

Tuesday, August 16, 2011, 10:00am to 4:00pm

  • Troy – NYS Department of Health Capital District Regional Office
  • Saratoga Conference Room, Frear Building, One Fulton Street, Troy, NY 12180
  • Minutes from August 16 Managed Long Term Care Implementation and Waiver Redesign Work Group meeting
  • Recorded Conference Call from August 16 Managed Long Term Care Implementation and Waiver Redesign Work Group meeting

Monday, September 19, 2011, 11:00am to 4:00pm

  • Auditorium of the New York City College of Technology, Klitgord Center
  • 285 Jay Street, Brooklyn, NY 11201

The Managed Long Term Care Implementation and Waiver Redesign work group, a work group of the New York State Medicaid Redesign Team (MRT), will conduct a public hearing on September 19 from 11 a.m. – 4:00 p.m. to solicit public comment on the development and implementation of managed long term care and coordinated care models.

The hearing will be held in the Auditorium of the New York City College of Technology, Klitgord Center, 285 Jay Street, Brooklyn, NY 11201.

No pre-registration is required. Individuals wishing to speak will be asked to register on site. All presentations will be limited to five minutes to accommodate as many speakers as possible. The hearing will be webcast and can be viewed live at: http://www.health.ny.gov/events/webcasts/

People who are unable to attend the hearing, or who have more information to submit than time allows are invited to submit written comments to : mltcworkgroup@health.state.ny.us. Comments will also be posted on the Medicaid Redesign website.

More information on this Work Group and MRT initiatives is available at: http://www.health.ny.gov/health_care/medicaid/redesign/

The Work Group has been asked to advise DOH on:

  • development of care coordination models to be used in the mandatory enrollment of persons in need of community-based long term care services;
  • review processes to ensure that sufficient patient protections exist;
  • promulgate guidelines for network development;
  • assure that the contractual arrangements for benefit package services are sufficient to ensure the availability, accessibility and continuity of services; and
  • identify ways to promote access to services and supports in homes and communities, so individuals may avoid nursing home placement and hospital stays.

Specific areas that are of interest include but are not limited to: care coordination model draft principles; enrollment processes; integration of consumer direction; transition from fee for service; and consumer protections.

Care Coordination Model (CCM) Draft Principles

Wednesday, September 28, 2011, 10:00am to 4:00pm

  • NYC – NYS Department of Health Metropolitan Regional Office
  • 90 Church Street, 4thFloor Conference Room A/B, Manhattan

Thursday, October 27, 2011, 1:00 PM - 4:00 PM

  • NYC - United Hospital Fund
  • 12th floor, 1411 Broadway (btw. W. 39th and W. 40th Streets), Manhattan

PLEASE NOTE:Space for meeting observers is EXTREMELY limited (first 20-25 people only – others will be turned away). Bring picture ID for access to all buildings.

A conference call phone number to dial in to listen (only) to these meetings will be posted to the MRT Web site at least one day in advance of each meeting.

There will be a limited amount of seating available. Due to the security requirements of this building, individuals must pre-register in order to attend. If you would like to attend, please email mltcworkgroup@health.state.ny.us and include your first and last name.