LeadingAge New York State Budget Review April 2017 | 页面 18
Side Letter Provisions
Apart from issues included in State Budget legislation, DOH agreed to address a number of other concerns
that the Legislature raised during the budget negotiation process and that were included in the legislative one-
house budget proposals. A number of these centered on managed care premium adequacy. These provisions are
not reflected in statutory language but are memorialized in a side letter signed by Jason Helgerson, the state’s
Medicaid Director. It commits DOH to a number of actions. Those impacting MLTC are summarized below.
Rate Cells
In the side letter, the Executive commits to explore separate rate cells or risk adjustment for nursing home
services, high cost/high need home and personal care services, and Health and Recovery Plan (HARP, i.e.,
mental health) services. DOH will re-engage in discussions with CMS with the assistance of stakeholders
impacted by the issue.
UAS
In the side letter, the Executive commits to analyzing and formulating recommendations regarding the
Universal Assessment System (UAS) Tool. DOH will hold regular meetings with stakeholder groups identified
by DOH and the Legislature as well as DOH staff from departments that work with the UAS and UAS data.
Waiver Transition
In the side letter, DOH agrees to delay the transition of the Nursing Home Transition and Diversion (NHTD)
and Traumatic Brain Injury (TBI) waivers into Medicaid managed care for an additional year, until Jan. 1, 2019.
Rate
In the side letter, DOH commits to provide quarterly updates to the Legislature on Medicaid Managed Care
rates. This will include quarterly meetings with the Chairs of the Health Committees as well as the Chairs of the
Senate Finance and Assembly Ways and Means Committees. DOH will provide the Legislature with actuarial
memoranda and presentation materials disseminated at monthly managed care policy and planning meetings.
For more information, contact Darius Kirstein at [email protected] or 518-867-8841.
LeadingAge New York/April 2017
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