NYSACRA

NEW ARTICLE 16 CLINIC REGULATIONS
(Part 679.6(i)(2)– CLARIFICATION

Many of you are aware that a Clinic Task Force of the Provider Council has been meeting about recent issues in Article 16 and Article 28 PT clinics.  A related new regulation that was previously disseminated, Part 679.6(i)(2), takes effect today, August 15. 2003.  The Clinic Task Force has been providing input to OMRDD to change the language of that new regulation, however, there hasn’t been time to make that happen before the 8/15/03 compliance date.  In light of this, OMRDD has issued a letter of direction that outlines what needs to be done to comply.  It essentially follows the Clinic TF recommendations and is o­nline at:
www.nysacra.org/nysacra/art16update.pdf (pdf 60kb).

NYS-OPTS OR ORGANIZED HEALTHCARE DELIVERY

This week NYSACRA met with Commissioner Maul, Helene DeSanto and Jim Moran, OMRDD about NYS-OPTS.  In the meeting we mainly talked about the kinds of pilots or demos we are interested in.  We also stated that a number of the main concerns needed to be addressed before we wholeheartedly support the implementation of NYS-OPTS, such as the issue with subcontracting to providers.  The dialogue with the Commissioner was very helpful and frank and the NYSACRA members and staff present felt better about the direction.  We understand from our meeting that there will not be an RFP…simply submit proposals.   Highlights from the meeting are as follows:

1)      Pilots need not be financially neutral
2)      Be adventuresome
3)      Pick different parts of your operation to focus o­n
4) There will be significant OMRDD central office involvement in selection and monitoring of pilots
5)      Now is the time for brainstorming
6)      Consumer satisfaction should be a component
7)      Risk is the biggest hurdle to overcome
8)      Describe a demo period in the proposals
9)      Proposals should have an evaluation protocol
10) Looking to do business differently
11) Not looking for savings
12)   Number of pilots approved will depend, in part, o­n system’s ability to manage multiple projects
13)   Feds are looking at Olmstead
14)   When developing pilot proposals, keep CMS requirements in mind
15)   Pilots can mix Medicaid and Non-Medicaid funds
16)   What would be different with NYS-OPTS: providers would no longer be Medicaid providers. OMRDD would be. OMRDD will have to meet all CMS requirements, but voluntaries’ relationship with OMRDD is contractual.
17)   It is Flexible; if something is not working we’ll shift gears.

NYSACRA intends to act as a resource or conduit for developing pilots and in the future we may hold several conference calls to “spark” ideas and to pass pilot concepts along.

ANOTHER REMINDER: PLEASE FAX US YOUR
AGENCY INFORMATION FORMS!

We are in the process of updating our next Membership Directory.  For those that have not yet done so, please promptly return the Agency Information Form that we had sent you last month. It is important for communication purposes and to note any changes in addresses, phone numbers and personnel. If you need another copy, please call the NYSACRA offices and we’ll be happy to send you a new o­ne.