New York Medicaid Redesign Team Meeting

  • Meeting is also available in Portable Document Format (PDF)
List of MRT Proposals for Feb. 24–25 MRT Meetings
# Proposal Short Title
5 Reduce and Control Utilization of Certified Home Health Agency Services
6 Reduce Medicaid Managed Care and Family Health Plus Profit (from 3% to 1%)
10 Eliminate Direct Marketing of Medicaid Recipients by Medicaid Managed Care Plans
11 Bundle Pharmacy into MMC
13 Preschool/School Supportive Health Services Program (SSHSP) Cost Study
14 Restructure Reimbursement for Proprietary Nursing Homes
15 Comprehensive fee–for–service pharmacy reform
17 Reduce fee–for–service dental payment on select procedures
18 Eliminate spousal refusal.
21 Streamline the Processing of Nursing Home Rate Appeals
24 Payment for Enteral Formula with Medical Necessity Criteria
25 Remove Physician Component from Ambulatory Patient Group (APG) Base Rates
26 Utilization Controls on Behavioral Health Clinics
29 Reduce Transportation Costs through Regional Management Recommended Targeted Fee Actions
30 align Payment for Prescription Footwear with Medical Necessity
31 Eliminate worker recruitment and retention
34 Establish Utilization Limits for PT, OT, and Speech Therapy/Pathology
37 Eliminate Case Mix Adj for AIDS Nursing Svcs in CHHA and LTHHCP Programs
41 Establish the Public Health Services Corps
42 Limit MA coverage for compression stockings to the MC criteria, include coverage during pregnancy.
49 Reimburse Art 28 clinics for HIV counseling/testing using APGs
54 Adjust 340B Drug payment in 340B–eligible clinics via Ambulatory Patient Groups (APGs)
55 Increase coverage of tobacco cessation counseling
60 Delink Workers Compensation and No Fault Rates from Medicaid
61 Home Care Worker Parity – CHHA / LTHHCP / MLTC
67 Assist Preservation of Essential Safety–Net Hospitals, Nursing Homes and D&TCs
68 Repatriate Individuals in out of state placements
69 Uniform Assessment Tool (UAT) for LTC
70 Expand current statewide Patient–Centered Medical Homes (PCMH)
82 Reduce Reimbursement for Hospital Acquired Conditions and Potentially Preventable Conditions
83 Expand SBIRT for alcohol/drug to hospital clinic, DTC and office settings.
89 Implement Health Home for High–Cost, High–Need Enrollees
90 Mandatory Enrollment in MLTC Plans/Health Home Conversion
93 Establish behavioral health organizations to manage carved–out behavioral health services
101 Develop Initiatives to Integrate and Manage Care for Dual Eligibles
102 Centralize Responsibility for Medicaid Estate Recovery Process
103 Reduce Inappropriate Use of Certain Services
104 Increase Enrollee Copayment Amounts for MA Fee–for–Service and FHP; Require Copayments for CHP
109 Require Hospitals and Nursing Homes to provide Patient Centered Palliative Care
116 Accelerate IPRO Review of Medically Managed Detox (Hosp)
121 Better utilize County Nursing Homes
129 State Authority to Supervise Integration of Health Services and Providers to Minimize Anti–Trust Exposure
131 Reform Medical Malpractice and Patient Safety
132 Expand the Definition of Estate
133 Administrative Renewal for Aged and Permanently Disabled
134 Audit Cost Reports (rather than certification)
137 Disregard retirement assets such as 401K plans for MBI–WPD
139 Implement the new waiver for LTHHCP
141 Accelerate State Assumption of Medicaid Program Authorization
144 Eliminate Duplicative Surveillance Activities (Labs/psychiatry)
147 Eliminate or modify unnecessary regulations and improvements for capital access
150 Develop an Automated Exchange/Medicaid Eligibility System
153 Develop innovative telemedicine applications by reducing regul. barriers and providing $ incentives
154 Enhance and improve the State's Medicaid program integrity efforts.
164 align Medicare Part B clinic coinsurance with Medicaid coverage and rates
191 Decrease the Incidence and Improve Treatment of Pressure Ulcers
196 Supportive Housing Initiative
200 Change in scope of practice for mid–level providers to promote efficiency and lower Medicaid costs.
209 Expand Hospice
217 Create an office for development of patient–centered primary care initiatives
243 Accountable Care Organizations (ACOs)
264 Apply HCRA Surcharges to Physician Office Based Surgery and Radiology Services
889 Redesign NYS bedhold policy for nursing homes.
990 Adjust Reimbursement Rates to Support Efforts to Address Health Disparities
1021 Facilitating Co–Located physical health/behavioral health/developmental disabiilty services
1029 Enrollment and Retention Simplification
1032 Establish a Housing Disregard as Incentive to Join MLTC
1058 Maximize Peer Services
1116 Apply 60 Month Look Back Period to Non–Institutional LTC
1172 Nursing Home Sprinkler Loan Pool
1427 Allow consumer direction in MLTC; provide regulatory framework for CDPAP
1434 Convert a portion of Family Planning grants to Medicaid rate reimbursement
1451 Establish various MRT workgroups
1458 Managed Care Population and Benefit Expansion, Access to Services, and Consumer Rights
1462 LTC insurance proposals
4648 Family Planning Benefit Program as a State Plan Service
4647 Expand Managed Addiction Treatment Program (MATS)
4651 Global Spending Cap on Medicaid Expenditures
4652 Reform Personal Care Services Program in NYC