FIDA Demonstration Start Date Delayed

Carl J. Pucci in Finance & Reimbursement

DOH and CMS have announced that the Fully Integrated Duals Advantage (FIDA) demonstration start date is being adjusted to January 1, 2015 (from October 1, 2014).  Please see below for further details.

After a joint review of the plans’ readiness for the FIDA Demonstration, the NYS Department of Health (NYSDOH) and Centers for Medicaid and Medicare Services (CMS) have agreed to adjust the start date to January 1, 2015.

NYSDOH and CMS have set high standards for plans to participate in the FIDA Demonstration. The plans need to meet all of the requirements set by NYSDOH and CMS for the FIDA Demonstration.  These standards go beyond existing Medicare and Medicaid requirements and so additional time will allow plans an opportunity to meet them.

It is the priority for NYSDOH and CMS to make participants’ transition to the FIDA Demonstration as smooth as possible, without any interruption to provision of current services including long-term care services and supports. NYSDOH and CMS have decided to give the plans three additional months to complete readiness review activities and cure remaining deficiencies before FIDA will begin.  The additional time will allow NYSDOH and CMS to make sure that participants are educated about the FIDA Demonstration, have a robust choice of providers, and receive high-quality services.  It will also ensure that plans and providers are trained and ready to implement the FIDA Demonstration.

  • Individuals in Bronx, Kings, Nassau, New York, Queens, and Richmond counties will be able to join the FIDA Demonstration on January 1, 2015. Passive enrollment will be phased in beginning April 1, 2015 until all eligible individuals are enrolled.
  • Individuals in Suffolk and Westchester will be able to join the FIDA Demonstration no earlier than April 1, 2015. Passive enrollment will begin no earlier than July 1, 2015 until all eligible individuals are enrolled.

NYSHFA CONTACT:

Carl J. Pucci
Director, Finance & Reimbursement
518-462-4800 x36