Education & News
In the rapidly transforming world of healthcare, VNSNY CHOICE understands how important it is for you to stay up to date on changes that affect you, your practice, and your patients. Below are notices, recommendations, and updates that can help you keep track of changing standards and regulations. Check back regularly for new postings.
FIDA Open in Suffolk and Westchester Counties
It is with great enthusiasm that NYS Department of Health (NYSDOH) announces the expansion of the Fully Integrated Duals Advantage (FIDA) Demonstration to Suffolk and Westchester Counties. Eligible individuals can enroll now through NY Medicaid Choice.
The FIDA Demonstration was originally approved to run January 1, 2015 through December 31, 2017. In November, it was extended through December 2019. NYSDOH and the Center for Medicare and Medicaid Services (CMS) are committed to delivering maximum integration of care to dual eligibles to help ensure all medically necessary services are provided, care in the community is promoted, and avoidable hospitalizations and nursing facility stays are reduced.
FIDA fully integrates Medicare and Medicaid benefits in a way not previously available in New York State. Although the program is approaching the end of the second demonstration year, we are still early in terms of understanding the impact of FIDA; particularly following the updates made last winter. There have been many success stories of how FIDA has improved the lives of its participants, but the first round of preliminary data from the independent evaluation is still likely at least six months away. The two-year extension allows more time to assess the positive impact of FIDA on quality and cost of care.
Medicare Outpatient Observation Notice Memo
The purpose of this memo is to announce the availability of the OMG-approved standardized Medicare Outpatient Observation Notice (MOON), form CMS-10611. The Medicare Outpatient Observation Notice was developed to inform all Medicare beneficiaries when they are an outpatient receiving observation services and are not an inpatient of the hospital or critical access hospital (CAH). All hospitals and critical access hospitals must provide this statutorily required notification no later than March 8, 2017. Read the Medicare Outpatient Observation Notice Memo.
Medicare Outpatient Observation Notice Instructions
In accordance with the new statute, this notice must include the reasons the individual is an outpatient receiving observation services and the implications of receiving outpatient services, such as required Medicare cost-sharing and post-hospitalization eligibility for Medicare coverage of skilled nursing facility services. Hospitals and critical access hospitals must deliver the notice no later than 36 hours after observation services are initiated or sooner if the individual is transferred, discharged, or admitted. Read the Medicare Outpatient Observation Notice Instructions. For more information and updates on this statute, visit https://www.cms.gov/Medicare/Medicare-General-Information/BNI/index.html?redirect=/BNI/.
Important Changes for Opioid Analgesics Coverage with VNSNY CHOICE SelectHealth
Effective October 1, 2016, Opioid Analgesics are subject to certain quantity limits. Read the CHOICE SelectHealth Provider News Update.
CHOICE Medications Adherence Tip Sheet
VNSNY CHOICE knows the importance of medication adherence. This Medication Adherence tip sheet is a very useful tool that will make it easy for providers to help CHOICE members take the right meds at the right time — no matter how complex their medication regimens. In addition, the tip sheet will help empower members and caregivers to easily see what medications to take and when to take them. Read the CHOICE Medications Adherence Tip Sheet.
Medicaid Fee for Service (FFS) Mosquito Repellent Coverage
NYS FFS Medicaid will provide coverage for mosquito repellent when prescribed to enrollees who intend to travel to, or return from a Centers of Disease Control (CDC) recognized area of localized Zika transmission. Read the Department of Health notice for more information.
FIDA Alert: New Flexibility for FIDA Providers
The New York State Department of Health (DOH) and Centers for Medicare & Medicaid Services (CMS) have made several reforms to the FIDA program. Find out how this easing of provider requirements can affect your practice. Read the FIDA Provider Notification.
The ICD-10 FAQ document is intended to provide a general overview of what can be expected with the transition from ICD-9 to ICD-10 as it impacts VNSNY CHOICE providers. Read the ICD-10 FAQ document.
JNC8: Recommendations: Changes in Diagnosis and Treatment of Hypertension
Hypertension is one of the most important preventable contributors to disease and death in the United States, leading to myocardial infarction, stroke, and renal failure when it is not detected early and treated appropriately. The Eighth Joint National Committee (JNC8) recently released evidence-based recommendations on treatment thresholds, goals, and medications in the management of hypertension in adults. Read JNC8 Recommendations: Changes in Diagnosis and Treatment of Hypertension.