2019 FMA Conference

The FMA conference in Cooperstown which took place on May 8-10 was a huge success with great presentations from industry experts and State representatives.

It was an honor sponsoring the keynote speaker Dr. Bird (Stephen Birchak). His presentation was the highlight of the conference.

Congratulations to Laurie Davis, Executive Director at Oswego Industries, the winner of Millin Associates grand price – 64GB VR Oculus Headset.

The famous Dr Bird (Stephen Birchak)
Michael Ogborn, CFO at New York State DOH

 

 

 

 

 

 

 

 

 

Jim Wisz and Marcel Handler from Millin Associates presentation on the challenges to watch out for during the managed care transition

Laurie Davis, Exec. Director, 
 Oswego Industries, 
Winner of the VR Headset

 

 

 

 

 

 

 

 

 

 

The Millin Team

 

 

 

 

 

 

 

 

 

 

 

 

Dear OPWDD Community Habilitation Provider, Beginning July 1, 2019, New York State is implementing the Community First Choice Option (CFCO). CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Through CFCO, New York State is expanding access and availability by offering some services and supports that have, until now, only been available through waivers.

Governor Andrew M. Cuomo today announced $204 million to support 95 projects that will protect and transform New York State’s health care system. This funding from the Statewide Health Care Facility Transformation Program will improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout the State

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Discontinuation of Functional Reporting for PT, OT, and SLP Services

The Functional Reporting requirements of reporting the functional limitation nonpayable HCPCS G-codes and severity modifiers on claims for therapy services and the associated documentation requirements in medical records have been discontinued, effective for dates of service on and after January 1, 2019. The below instructions apply only to dates of service when the functional reporting requirements were effective, January 1, 2013 through December 31, 2018.
For more information regarding the ending of Functional Reporting please see the pages for Therapy Services (section II.L.) of CMS-1693-F on the CMS web page at the following link for Physician Fee Schedule (PFS) Federal Regulation Notices:   https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Federal-Regulation-Notices.html.

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Ten Opportunities to Better Serve Individuals Dually Eligible for Medicaid and Medicare

Over 12 million individuals are concurrently enrolled in Medicaid and Medicare. Such dually eligible individuals may either be enrolled first in Medicare by virtue of age or disability and then qualify for Medicaid on the basis of income, or vice versa. Dually eligible individuals experience high rates of chronic illness, with many having multiple chronic conditions and/or social risk factors.i Forty-one percent of dually eligible beneficiaries have at least one mental health diagnosis, and about half use long term services and supports (LTSS)

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MAPP HHTS Release 2.8 Updates

Below is a summary of major changes that will be made to the MAPP HHTS during Release 2.8, which is currently scheduled to be deployed on January 10th. A number of fields will be added to files in the release, so in addition to the below, please reference the MAPP HHTS File Specifications V6.0 excel document. A more detailed File Specifications document will be issued in the near future. More detail related to changes implemented in this release will also be presented during the December 12th biweekly webinar.

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Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing Proposed Rule (CMS-4180-P)

The Centers for Medicare & Medicaid Services (CMS) is committed to implementing President Trump’s blueprint to lower drug costs and reduce out-of-pocket costs for patients. In line with the policies discussed in the President’s blueprint, CMS issued a proposed rule on November 26, 2018 that solicits public comments on potential policies that would remove administrative hurdles to offer lower cost options to seniors and provide support for private sector partners by providing them the tools to lower the cost of prescription drugs. Read More Here…

NEW YORK STATE ANNOUNCES PUBLIC LISTENING SESSIONS TO STUDY ACCESSIBLE RIDE SHARING SERVICES FOR CUSTOMERS WITH DISABILITIES

The New York State Transportation Network Company Accessibility Task Force announced that five public listening sessions will be held across the state to examine the availability of accessible ride sharing services for people with disabilities. Through these listening sessions, the task force will analyze current service options, the need and demand for accessible services, and identify opportunities and barriers to increasing these options for customers with disabilities. Read More Here…

CMS overhauls Medicare billing, telehealth standards

The CMS on Thursday finalized a rule that will pay doctors for virtual visits and overhaul Medicare billing standards for office visits that haven’t changed since the 1990s.

The agency will now pay doctors for telehealth visits and communication with patients, acknowledging the time those efforts take.

The CMS also will change how physicians bill Medicare for patient visits under a relatively generic set of codes that distinguish level of complexity and site of care, known as evaluation and management visit codes

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