MRT 101 - Develop initiatives to integrate and manage care for eligible duals
Fully Integrated Duals Advantage (FIDA) Enrollment Update
After a joint review of the plans’ readiness for the FIDA Demonstration, NYS Department of Health (NYSDOH) and Centers for Medicaid and Medicare Services (CMS) have agreed to adjust the start date to January 1, 2015.
NYSDOH and CMS have set high standards for plans to participate in the FIDA Demonstration. The plans need to meet all of the requirements set by NYSDOH and CMS for the FIDA Demonstration. These standards go beyond existing Medicare and Medicaid requirements and so additional time will allow plans an opportunity to meet them.
It is the priority for NYSDOH and CMS to make participants’ transition to the FIDA Demonstration as smooth as possible, without any interruption to provision of current services including long-term care services and supports. NYSDOH and CMS have decided to give the plans three additional months to complete readiness review activities and cure remaining deficiencies before FIDA will begin. The additional time will allow NYSDOH and CMS to make sure that participants are educated about the FIDA Demonstration, have a robust choice of providers, and receive high-quality services. It will also ensure that plans and providers are trained and ready to implement the FIDA Demonstration.
- Individuals in Bronx, Kings, Nassau, New York, Queens, and Richmond counties will be able to join the FIDA Demonstration on January 1, 2015. Passive enrollment will be phased in beginning April 1, 2015, until all eligible individuals are enrolled.
- Individuals in Suffolk and Westchester will be able to join the FIDA Demonstration no earlier than April 1, 2015. Passive enrollment will begin no earlier than July 1, 2015, until all eligible individuals are enrolled.
Fully Integrated Dual Advantage (FIDA) Demonstration
- FIDA Marketing FAQ 10.16.14 (PDF, 348KB)
- Frequently Asked Questions (FAQs) - September 2013 (PDF, 106KB)
Memorandum of Understanding (MOU)
- Regarding a Federal-State Partnership to Test a Capitated Financial Alignment Model for Medicare-Medicaid Enrollees (PDF, 1.07MB)
- CMS Press Release (PDF, 95KB)
- CMS Fact Sheet (PDF, 95KB)
FIDA Funding Opportunity
The New York State Department of Health (NYSDOH) recently issued a Request for Applications to announce a funding opportunity for a statewide Ombudsman Program for Managed Long-Term Care (MLTC) and Fully Integrated Duals Advantage Program (FIDA) Participants. Additionally, this program will also provide Ombudsman services for beneficiaries of Long-Term Support Services (LTSS) in Mainstream Managed Care (MMC) plans.
The Ombudsman will be an independent, conflict-free entity that will act as a resource and advocate for MLTC, FIDA and LTSS MMC participants and their families/caregivers. NYSDOH intends to award one contract for the Ombudsman Program. The anticipated multi-year contract period is: May 1, 2014 – April 30, 2019.
For more information please click on the NYSDOH funding link below: http://www.health.ny.gov/funding/rfa/1312200945/index.htm
- Applications Due Date: 4/11/2014 by 4:00 PM
- Deadline to Submit Questions: 3/21/14
- Questions and Answers and Updates posted: 3/28/14
- Contract term: May 1, 2014 – April 30, 2019
- Contact: Karis Browder at FIDA@health.state.ny.us
FIDA Update Webinar
- January 10, 2014 - FIDA Update Stakeholder Webinar
- FIDA Update Stakeholder Meeting Presentation (PDF, 1.64MB)
- If you have any immediate questions, please contact us at 518-408-1600 or via email at email@example.com.
August 29, 2013 - FIDA Stakeholder Webinar
- FIDA Stakeholder Meeting Presentation (PDF, 223KB)
- FIDA Stakeholder Meeting Webinar (WMV, 22.2MB)
- For questions, please email FIDA@health.state.ny.us
- Addendum to FIDA Demonstration Proposal and Request for Public Comment (PDF, 400KB, 2pg.)
- 4/24/13 FIDA Demo Proposal Addendum Webinar Presentation (PDF, 225KB)
- 4/24/13 FIDA Demo Proposal Addendum Webinar Audio (WMV, 1.1MB)
- 4/18/13 FIDA Update Presented at the Managed Care Policy and Planning Meeting (PDF, 171KB)
- 3/13/13 FIDA Stakeholder Webinar Audio (36.2MB)
- Frequently Asked Questions on Fully Integrated Duals Advantage (FIDA) (PDF, 153KB)
- Request for Public Comment: NYSDOH Demonstration Proposal to Integrate Care for Dual Eligible Individuals
- Draft Proposal - Demonstration to Integrate Care for Dual Eligible Individuals (PDF, 18MB, 47pgs.)
- Second Draft Proposal - Demonstration to Integrate Care for Dual Eligible Individuals (PDF, 1.36MB, 74pgs.)
- Final Demonstration to Integrate Care for Dual Eligible Individuals (PDF, 5.38MB, 96pgs.)
- 9.30.11 Letter of Intent for Dual Eligible Demo Project
- Demonstration Proposal to Integrate Care for Dual Eligible Individuals: FIDA Update Power Point (PDF)
Fully-Integrated Duals Advantage (FIDA) Stakeholder Workgroup
- In response to many questions from entities in regard to the Fully Integrated Duals Advantage program (FIDA) the state will be posting frequently asked questions documents shortly, however we can clarify one question.
- Q: Will an applicant be disqualified from participating in the program if they are unable to upload a state license ?
- A: No; An applicant will not be disqualified from participating in the 2014 Capitated Financial Alignment program (FIDA in NYS) for failure to upload a state license or other document to CMS by the February 21, 2013 application deadline. Rather, the lack of a State license on February 21st will be treated as a deficiency that can be remedied during the cure period pursuant to section 2.3.4 of the instructions.
Workgroup on Plan Qualifications and Quality Metrics Meeting Summary
- Plan Qualifications and Quality Metrics Workgroup members (PDF, 51KB, 2pgs.)
- Meeting Summary 9.12.12 (PDF, 94KB, 6pgs.)
- Meeting Summary 9.24.12 (PDF, 138KB, 5pgs.)
- Meeting Summary 10.22.12 (PDF, 80KB, 3pgs.)
- Attachment: Performance Standards and Quality Measures (PDF, 177KB, 5pgs.)
- Attachment: Quality Measures (XLS, 49.5KB)
Workgroup on Navigation/Appeals/Grievances Meeting Summary
- Navigation/Appeals/Grievances Workgroup members (PDF, 51KB, 2pgs.)
- Meeting Summary 9.14.12 (PDF, 94KB, 6pgs.)
- Meeting Summary 10.4.12 (PDF, 101KB, 7pgs.)
- Meeting Summary 10.18.12 (PDF, 217KB, 4pgs.)
Workgroup on Outreach/Enrollment/Consumer Engagement Meeting Summary
- Outreach/Enrollment/Consumer Engagement Workgroup Members (PDF, 53KB, 2pgs.)
- Meeting Summary 9.14.12 (PDF, 96KB, 7pgs.)
- Meeting Summary 10.9.12 (PDF, 95KB, 5pgs.)
- Meeting Summary 10.25.12 (PDF, 79KB, 3pgs.)
Workgroup on Finance and Reimbursement Meeting Summary
- Finance and Reimbursement Workgroup Members (PDF, 85KB)
- Meeting Summary 11.15.12 (PDF)
- Meeting Summary 12.14.12 (PDF)
- Meeting Summary 1.15.13 (PPT, 10.8MB)