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MEDICAID WRAP-AROUND FOR MEDICARE PART D
Yesterday, NYSACRA joined an unprecedented coalition of New York’s
leading organizations for the elderly, disabled, HIV/AIDS
community and mentally ill joined forces, calling on legislative
leaders to reject a proposed elimination of the Medicaid
wrap-around as of July 1, 2006, which would deny drug coverage to
hundreds of thousands of New Yorkers.
As New
York prepared for the implementation of Medicare Part D to take
effect January 1, 2006, it once again demonstrated compassion for
those in need by proposing the wraparound benefit. The wraparound
plan was designed to pay for supplies & medications, such as
barbiturates & benzodiazepines, not covered by the individual’s
Medicare D Drug Plan. In addition, the wraparound plan is able to
pay for medications that are not covered by a Medicare Part D
Plan’s formulary after the physician has made an exception request
and it has been denied. Unfortunately the proposed wraparound
benefit coverage ends July 1, 2006. NYSACRA Executive Director
Ann Hardiman and the other coalition leaders insisted that this
wraparound must be continued. Click these links for a copy of the
NYSACRA press
statement, the
coalition press release or the
letter to the Governor and Legislature.
NYS
LEGISLATIVE SPECIAL ELECTION RESULTS
One State Senate and six Assembly
seats were filled on February 28th. (D) Marc Coppola took Byron
Brown’s Senate seat; In the 8th Assembly District, (R) Philip
Boyle took Barraga’s seat; In the 139th AD, (R) Stephen Hawley
took Nesbitt’s seat; In the 17th AD, (R) Thomas McKevitt took
O'Connell’s seat; In the 59th AD, (D) Alan Maisel took Seddio's
seat; in the 67th AD, (D) Linda Rosenthal took Stringer's seat;
in the 74th AD, (D) Sylvia Friedman took Sanders’ seat. The terms
will last only 10 months, though the winners will have an
incumbent's advantage in the fall, when they may face a primary
and then the General Election.
LEADERS
AGREE ON NYS BUDGET SURPLUS
The
leaders agreed that another $750 million will be coming into the
state coffers for this year and next. The higher-than-anticipated
revenue comes from growth in personal income tax collections,
particularly from investment income, higher real estate transfer
taxes from the hot housing market and corporate franchise taxes.
Compensation on Wall Street, especially from year-end bonuses,
also is helping to bolster the total revenue. The leaders said in
a statement that they are on schedule to have a 2006-07 state
budget deal by the April 1st deadline.
OIG –
OFFICE OF INSPECTOR GENERAL - HHS AUDITS
Office
of the Inspector General MSC Audits - the US Department of Health
and Human Services Office of Inspector General has initiated an
audit of MSC. They continue to be done across the state with new
auditors being added recently. The auditors have been contacting
agencies one or two days prior to the audits.
OMRDD
has requested that agencies contact OMRDD Central Office to inform
them when an audit is scheduled. Agencies can email Gary Lind at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
. OMRDD is also suggesting that
agencies log all documents that are reviewed or given to the
auditors. Tips from those that have gone before you are below:
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There
were two auditors, one is more senior.
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They
checked one random record (the agency serves approximately 500
people in MSC). One larger agency had two checked
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The
Audit Manager started with the entrance interview and let the
agency know that: “This is an audit, not an investigation. Only
if during their audit they uncover suspected fraud will they
refer the issue to the investigation unit. It is really an
audit of NYS OMRDD by the Federal Government, not the individual
agencies. They noted that Medicaid pays NYS $400 per person per
month for MSC, and since "that's a ton of money", they want to
make sure that the money is being spent on services that are
meaningful (as opposed to just saying hello every month).”
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-
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OMRDD
is very worried that that feel they have to find something.
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They
did take copies of the documents they reviewed. Note that they
focused in on a one-month period, with a comparative that showed
that the records were not just a repeat of a previous or
following month, and that all the necessary approvals were
signed and in place.
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Be
sure to make copies of documents that OIG auditors take with
them or at least keep a log of them.
ART
EXHIBIT PROPOSALS DUE MARCH 15TH!!!!
Earlier
this year, we faxed you a Request for Proposals for our 7th Annual
Exhibit of Art & Reception that will be held during the Annual
Conference on Thursday, April 27th, 2006 at the Sagamore Hotel &
Resort in Bolton Landing, New York. Each year, the exhibit grows
with more and more incredible work by artists who have
developmental disabilities. If your agency is still interested in
participating, please complete the RFP and a short bio for each
artist who would like to show their work and return it to the
NYSACRA offices via fax (518) 449-1509 by March 15th. If you don’t
have a form, contact Joe Macbeth at (518) 449-7551 and he’ll fax
you one – please hurry while there is still space available!
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