State Health Department and CMS Forge Alliance to Improve Care to Dual Eligibles

ALBANY, NY (August 28, 2013) – The Centers for Medicare & Medicaid Services (CMS) and the New York State Department of Health (DOH) have established a federal-state partnership to implement the Medicare-Medicaid Alignment Initiative (Demonstration) that will better serve individuals eligible for both Medicare and Medicaid.

Under the partnership, DOH and CMS will contract with Fully Integrated Duals Advantage (FIDA) Plans, which are Medicare-Medicaid Plans (MMPs) that provide integrated benefits to people eligible for both Medicare and Medicaid. The FIDA plans oversee the delivery of covered Medicare and Medicaid services for enrollees who reside in New York City and the surrounding counties of Nassau, Suffolk and Westchester. The Demonstration will begin July 1, 2014 and continue until December 31, 2017.

The initiative is testing an innovative payment and service delivery model to alleviate health care fragmentation, improve coordination of services for Medicare-Medicaid enrollees, and enhance the quality of care. This demonstration is an important building block in the state's move to "Care Management for all" in Medicaid.

Through FIDA, New York will provide eligible individuals with seamless access to all physical health, behavioral health, and long-term supports and services; a choice of plan and providers, with choices being facilitated by an independent, broker; and care planning and coordination by patient-centered interdisciplinary teams. In addition, this demonstration will allow FIDA plans to test alternative payment arrangements with their network providers.

"We are delighted to partner with CMS to offer access to more coordinated care to Medicare-Medicaid beneficiaries with long-term care needs," State Health Commissioner, Nirav R. Shah, MD, MPH, said. "Providing customized services that address each individual's medical, behavioral and social needs is critical to improving the health and well-being of this population."

Many existing managed long term care plans are expected to participate in the demonstration, which will help ensure continuity of coverage and care for individual enrollees.

The demonstration will build upon the existing infrastructure of New York's Medicaid Managed Long Term Care programs by increasing consumer protections, improving education and information, and consolidating appeals and grievances. Ombudsman services will help support individual advocacy and provide independent oversight.

DOH will present details of the arrangement during a FIDA stakeholder webinar to be held on Thursday, August 29, 2013 from 3:30 to 5:00 p.m. To register for the "FIDA Stakeholder Meeting" webinar, please go to:

A fact sheet about the DOH-CMS partnership is available at: