News & Views 12.30.10

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OPWDD ALERTS PROVIDERS TO POTENTIAL IMPACT OF HEALTH CARE REFORM MANDATES ON HEALTH REIMBURSEMENT ARRANGEMENTS

GROUNDBREAKING HOUSING LEGISLATION PASSES CONGRESS

CMS INNOVATION CENTER

GUIDANCE FOR OIG AUDIT

NYSACRA LEGISLATIVE DAY IS FEBRUARY 15, 2011 IN ALBANY - REGISTER NOW!

NYSACRA WISHES ALL OF OUR MEMBERS A VERY HAPPY AND HEALTHY NEW YEAR!

The New York State Office for People with Developmental Disabilities has issued an advisory to alert the field to potential impact of health care reform requirements on health reimbursement arrangements (HRA)/health care adjustments. OPWDD understands that certain employers may be prohibited from imposing annual limits on HRA benefits. OPWDD urges agencies to confer with benefits/plan advisor(s) to determine whether you would be impacted by the new health care reform mandates. To obtain the advisory from OPWDD, click here. NYSACRA is seeking clarification of the new rules by experts in the field as well and will alert members as to our findings.

Last week, legislation to reform the United States Housing and Urban Development agencies' Section 811 supportive housing for persons with disabilities program was approved by the House of Representatives. The Frank Melville Supportive Housing Investment Act of 2010 makes "long overdue" improvements to the Section 811 program including: modernizing and simplifying the capital advance program for not for profit sponsors; integrates supportive housing for people with disabilities into larger multi-family affordable rental housing developments; protects the existing tenant-based program for people with disabilities; and creates an innovative subsidy approach which allow states to leverage additional capital funds to create new supportive housing units. The measure passed the U.S. Senate on December 17th.

The new Center for Medicare and Medicaid Innovation www.innovations.cms.gov created by the Affordable Care Act, aims to explore innovations in health care delivery and payment that will enhance the quality of care for Medicare and Medicaid beneficiaries, improve their health, and lower costs. To initiate its work, the Innovation Center will have a series of open forum calls and in-person regional community listening sessions that are open to the public and will be hosted by Richard Gilfillan, M.D., Acting Director of the Innovation Center. These meetings will help Innovation Center leaders obtain input regarding the Center's goals, operating plans and priorities. In conjunction with the launch of the Innovation Center, CMS is also announcing new initiatives to improve care for Americans enrolled in Medicare and Medicaid. These initiatives include:

• Expansion of the Multi-Payer Advanced Primary Care Practice Demonstration: Eight states have been selected to participate in a demonstration project to evaluate the effectiveness of doctors and other health professionals across the care system working in a more integrated fashion and receiving payment from Medicare, Medicaid, and private health plans. Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota will participate in this demonstration.
• Announcement of the Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration: This demonstration will test the effectiveness of doctors and other health professionals working in teams to treat low-income patients at community health centers.
• Launch of the Medicaid Health Home State Plan Option: This new State plan option allows patients enrolled in Medicaid with at least two chronic conditions to designate a provider as a "health home" to help coordinate treatments for the patient. States that implement this option will receive enhanced financial resources from the federal government to support "health homes" in their Medicaid programs.

The Innovation Center also announced an upcoming opportunity for demonstration projects that will examine programs that fully integrate care for individuals who are eligible for both Medicare and Medicaid (i.e., dual eligibles). Significant health benefits and savings can come from better coordinating the care of low-income seniors and people with disabilities. States may apply for resources to support the demonstration projects they design beginning in December and the Innovation Center will award up to 15 state program design contracts up to $1 million each.

OPWDD has shared some guidance with the 74 providers who have been identified as the agencies that are part of the Upstate Phase of the OIG audit, based on the audit of New York City providers. NYSACRA offers these materials for our general membership, since they consolidate and simplify ADM requirements for each service into one form, along with concise direction on common audit issues. You can access the materials here: Guidance Document for HSBC Waiver Services, Additional Documentation that may be requested by OIG, and HCBS Waiver Services Review Charts.

Plans are underway for the 2011 NYSACRA Legislative Day to be held at the Empire State Plaza in Albany. 2011 is certain to be a busy year full of real challenges and unique opportunities. Now, more than ever, we should make the most of opportunities for our voices to be heard by public officials in Albany and our February 15th Legislative Day is the perfect venue! The timing of the 2011 Legislative Day is perfect as the proposed 2011-12 Executive Budget will have just been released. If you have not done so already, please complete the registration form and send back to Lisa Mount at This e-mail address is being protected from spambots. You need JavaScript enabled to view it '; document.write( '' ); document.write( addy_text32304 ); document.write( '<\/a>' ); //--> This e-mail address is being protected from spambots. You need JavaScript enabled to view it . We have also included for you the list of hotels for overnight accommodations on February 14th. If you have questions about Legislative Day, please do not hesitate to contact Lisa or Katie Mayo at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

We look forward to seeing you on February 15th!