New York Signs Memorandum of Understanding with CMS

Becomes Seventh State to Adopt Medicare-Medicaid Dual Eligibles Initiative

On August 26, 2013, the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH) signed a Memorandum of Understanding (MOU) establishing the Medicare-Medicaid Alignment Initiative (MMAI) in New York (the Demonstration). New York is now the seventh state to implement the MMAI, after Massachusetts, Washington, Ohio, Illinois, California, and Virginia.

Seventeen other states have active proposals submitted to CMS. The MMAI is a joint federal and state project which seeks to improve care and reduce costs associated with beneficiaries eligible for both Medicare and Medicaid, or “dual eligibles.”

In New York, the Demonstration is called the Fully Integrated Duals Advantage. It functions to enroll dual eligibles into managed care plans called Fully Integrated Duals Advantage (FIDA) Plans, and provide long-term care services and supports (LTSS). Starting no earlier than July 2014, the Demonstration will eventually coordinate care to 170,000 dual eligible in eight counties.

The MOU and its appendices “are not intended to create contractual or other legal rights between the parties,” so details will be provided in future three way contracts between CMS, DMAS, and the FIDA Plans.

The National Council on Medicaid Home Care – a NAHC affiliate – has examined New York’s dual eligible MOU with CMS in detail. To review the full brief, please click here.

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