Long-term proposals to be considered by MRT post-March

• Proposal is also available in Portable Document Format (PDF)

MRT Long Term Proposals for Feb 24–25, 2011

Proposal #	Short Title	Theme
19	Eliminate D&TC Bad Debt and Charity Care	Recalibrate Medicaid Benefits and Reimbursement Rates
27	Eliminate Empire Clinical Research Investigator Program (ECRIP) Funding	Recalibrate Medicaid Benefits and Reimbursement Rates
33	Inpatient Rehabilitation (IPR) Redesign to Enhance FFP	Recalibrate Medicaid Benefits and Reimbursement Rates
36	Contract Dental Management Vendor for Fee For Service & Medicaid Managed Care Recipients	Recalibrate Medicaid Benefits and Reimbursement Rates
51	Limit Coverage of Eyeglass Replacement	Recalibrate Medicaid Benefits and Reimbursement Rates
53	Revise Inpatient Detox Reimb. to Incentivize Step-Down Care	Recalibrate Medicaid Benefits and Reimbursement Rates
63	Reimbursement for dedicated preconception visits	Recalibrate Medicaid Benefits and Reimbursement Rates
64	Provide direct reimbursement for Nurse Practitioners and Physician Assistants in clinics.	Recalibrate Medicaid Benefits and Reimbursement Rates
73	Reimburse Local Health Departments for environmental lead investigations for children	Recalibrate Medicaid Benefits and Reimbursement Rates
74	Increase Medicaid payment for vaccine administration	Recalibrate Medicaid Benefits and Reimbursement Rates
80	Reassess Prescription Drug Purchasing Policies	Recalibrate Medicaid Benefits and Reimbursement Rates
81	Implement Statewide Program to Encourage NHs to Refinance Mortgages	Recalibrate Medicaid Benefits and Reimbursement Rates
87	Reduce Unnecessary Hospitalizations - Geographic Community Based Pay for Performance	Pay Providers Based On Performance
88	Incentivize providers to screen for BH issues in children	Recalibrate Medicaid Benefits and Reimbursement Rates
107	Tax Credits for Relatives to Contribute toward LTC Costs	Ensure Consumer Protection and Promote Personal Responsibility
117	Review Coler& Goldwater Memorial Hosp	Eliminate Fraud and Abuse
119	Enhance School Based Health Services Care	Empower Patients and Rebalance Service Delivery
124	Create and deploy a permanent, revolving Primary Care Capital Access Fund (PCCAF).	Empower Patients and Rebalance Service Delivery
125	Bonus for high volume Medicaid physicians	Empower Patients and Rebalance Service Delivery
128	Allow LTHHCPs to offer Hospice	Empower Patients and Rebalance Service Delivery
136	Eliminate 60/30 Day Notice Requirement	Eliminate Government Barriers to Quality Improvement and Cost Containment
140	Presumptive Eligibility for Long-term Care	Eliminate Government Barriers to Quality Improvement and Cost Containment
142	Eliminate Barriers to Recruiting and Retaining Healthcare Workforce.	Empower Patients and Rebalance Service Delivery
143	Continue improvements in State CON Program	Eliminate Government Barriers to Quality Improvement and Cost Containment
148	Reduce or eliminate the local County share of the Medicaid program	Eliminate Government Barriers to Quality Improvement and Cost Containment
152	Repeal Section 2801d of Public Health Law	Eliminate Government Barriers to Quality Improvement and Cost Containment
158	Requires use of BNE´s online Dr. Shopper Program	Eliminate Fraud and Abuse
172	Sole-source contract for eyeglasses	Recalibrate Medicaid Benefits and Reimbursement Rates
173	Impose Moratorium on Medicaid Rate Cuts	Recalibrate Medicaid Benefits and Reimbursement Rates
176	Site-specific Cost reporting	Recalibrate Medicaid Benefits and Reimbursement Rates
178	Reduce Spending & Phase–out LTHHCP	Recalibrate Medicaid Benefits and Reimbursement Rates
179	Establishing reimbursement for services delivered by community health workers	Recalibrate Medicaid Benefits and Reimbursement Rates
181	Coverage for obesity counseling/diabetes prevention services	Recalibrate Medicaid Benefits and Reimbursement Rates
182	Enhance coordination of benefits between Medicaid and the Women, Infants, and Children (WIC) Program.	Recalibrate Medicaid Benefits and Reimbursement Rates
183	Submit a 1915i State Plan for home and community-based services for HIV Medicaid population at risk of nursing home status	Recalibrate Medicaid Benefits and Reimbursement Rates
184	Urge Congress to enact a single payer national health care system (H.R. 676)	Recalibrate Medicaid Benefits and Reimbursement Rates
185	Prepaid Medicaid Services	Recalibrate Medicaid Benefits and Reimbursement Rates
186	Create and Enhanced Case Mix Adjustment for High Cost Patients with Complex Needs	Recalibrate Medicaid Benefits and Reimbursement Rates
187	Incentivize to Promote Innovation and Reform	Recalibrate Medicaid Benefits and Reimbursement Rates
188	Eliminate Transitional Care Units (TCU´s)	Recalibrate Medicaid Benefits and Reimbursement Rates
190	Convert Fee-for-Service LTHHCP Reimbursement to a Case Payment Based Methodology	Recalibrate Medicaid Benefits and Reimbursement Rates
192	Consolidate Low-income Health Insurance Programs	Ensure That Every Medicaid Member is Enrolled in Care Management
193	Phase out of Healthy NY	Ensure That Every Medicaid Member is Enrolled in Care Management
194	Capitation Partnership	Ensure That Every Medicaid Member is Enrolled in Care Management
195	Coordinate Services for Public Assistance	Ensure Consumer Protection and Promote Personal Responsibility
199	More marketing of programs such as premium assistance and MBI- WPD.	Ensure Consumer Protection and Promote Personal Responsibility
201	NH/ALP 6,000 Program Elimination	Empower Patients and Rebalance Service Delivery
203	Expand LTC Community Based Services; implement ACA provisions	Empower Patients and Rebalance Service Delivery
205	Improve access to care by utilizing Mobile Health Clinics	Empower Patients and Rebalance Service Delivery
206	Evaluation of Best Practices in Existing LTC Programs	Empower Patients and Rebalance Service Delivery
207	Establish the Center for Health System Innovation within the Dept of Health	Empower Patients and Rebalance Service Delivery
208	Accelerate State takeover of administration of Medicaid long-term care programs.	Empower Patients and Rebalance Service Delivery
210	Allow Nursing Homes to resize or develop non institutional alternatives with funding for transition	Empower Patients and Rebalance Service Delivery
212	Promoting Electronic Health Record (EHR) Adoption and Health Information Exchange (HIE)	Empower Patients and Rebalance Service Delivery
214	Rebalance long term care	Empower Patients and Rebalance Service Delivery
215	Enhance Nursing Home Care Coordination	Empower Patients and Rebalance Service Delivery
216	Prevention of unnecessary institutionalization	Empower Patients and Rebalance Service Delivery
218	State Take Over and Enforce the Collection of NAMI	Eliminate Government Barriers to Quality Improvement and Cost Containment
219	Advocate Changes to Federal EMTALA Rules	Eliminate Government Barriers to Quality Improvement and Cost Containment
221	Administrative Simplification	Eliminate Government Barriers to Quality Improvement and Cost Containment
222	Healthcare Information Technology Funding	Eliminate Government Barriers to Quality Improvement and Cost Containment
223	Consolidate and create ONE agency who will regulate and oversee ALL Long Term Care needs.	Eliminate Government Barriers to Quality Improvement and Cost Containment
224	Allow Electronic Fund Payments (EFT) in Medicaid	Eliminate Government Barriers to Quality Improvement and Cost Containment
225	Create an All Payer Claims System (expanded SPARCS system)	Eliminate Government Barriers to Quality Improvement and Cost Containment
226	Establish a Rate Setting Advisory Commission	Eliminate Government Barriers to Quality Improvement and Cost Containment
227	Consolidate Oversight of Health Coverage	Eliminate Government Barriers to Quality Improvement and Cost Containment
228	Adjust cost compared to Similar States	Eliminate Government Barriers to Quality Improvement and Cost Containment
229	Assisted Living facility discharge policy change	Eliminate Government Barriers to Quality Improvement and Cost Containment
234	Allow publicly traded companies to own and operate nursing homes	Eliminate Government Barriers to Quality Improvement and Cost Containment
235	Streamline Quality Reporting	Eliminate Government Barriers to Quality Improvement and Cost Containment
236	Reorganize ACF/AL survey process to focus on poor performing facilities and "look-alikes"	Eliminate Government Barriers to Quality Improvement and Cost Containment
239	Expedite Medicaid billing	Eliminate Fraud and Abuse
240	Audit to confirm consistency for supply and medication claims	Eliminate Fraud and Abuse
241	ACA Implementation - Basic Health Plan/Public Option	Better align Medicaid with Medicare and ACA
244	Salary Incentives to Residents in Medically Underserved Communities	Empower Patients and Rebalance Service Delivery
253	Allow use of non-enrolled providers and reimburse up to the FFS rate.	Recalibrate Medicaid Benefits and Reimbursement Rates
270	Improve eMedNY	Eliminate Fraud and Abuse
869	Adult Day Health Care as Medicare Covered Services	Empower Patients and Rebalance Service Delivery
981	Streamline Provider Credentialing and Enrollment	Eliminate Government Barriers to Quality Improvement and Cost Containment
982	Verification of DME Billing	Eliminate Fraud and Abuse
983	Access to Special Needs Equipment	Recalibrate Medicaid Benefits and Reimbursement Rates
984	Expand Medicaid Coverage for Alternative Treatment Modalities	Recalibrate Medicaid Benefits and Reimbursement Rates
986	Modify Preferred Diabetic Supply Program	Recalibrate Medicaid Benefits and Reimbursement Rates
987	Reimburse Article 28 clinics for services provided by Registered Nurses and Licensed Practical Nurses	Recalibrate Medicaid Benefits and Reimbursement Rates
989	Increase Medicaid reimbursement for primary care	Recalibrate Medicaid Benefits and Reimbursement Rates
1002	Include more staffing indicators in quality add-ons to Medicaid rate.	None
1014	Adopt Consumer Directed Models of Care for the Disabled	Empower Patients and Rebalance Service Delivery
1020	Limit Payment for Out of State Services to not Exceed NYS Published Rate	Recalibrate Medicaid Benefits and Reimbursement Rates
1022	Managed Long Term Care Network Development	Ensure That Every Medicaid Member is Enrolled in Care Management
1025	Establish Comprehensive Utilization Review	Ensure Consumer Protection and Promote Personal Responsibility
1027	Use of Standardized Medical Coding	Recalibrate Medicaid Benefits and Reimbursement Rates
1034	ACA - End Programs Once Coverage Available in Exchange	Better align Medicaid with Medicare and ACA
1044	Improve Pharmacy Benefit Case Management	Recalibrate Medicaid Benefits and Reimbursement Rates
1048	Mental Health Medications Carve–Out	Recalibrate Medicaid Benefits and Reimbursement Rates
1056	Medication Therapy Management (MTM) Services	Recalibrate Medicaid Benefits and Reimbursement Rates
1057	Drug Trial Period of 14 days	Recalibrate Medicaid Benefits and Reimbursement Rates
1085	Use Actual Acquisition Costs as Benchmark for Drug Reimbursement	Recalibrate Medicaid Benefits and Reimbursement Rates
1086	Mandate Payment of Copayment	Recalibrate Medicaid Benefits and Reimbursement Rates
1096	Improve the Pharmacy Reimbursement Policies	Recalibrate Medicaid Benefits and Reimbursement Rates
1110	Refocus OMIG on Eliminating Fraud and Abuse	Ensure Consumer Protection and Promote Personal Responsibility
1112	Support Passage of Collaborative Drug Therapy Management (CDTM)	Eliminate Government Barriers to Quality Improvement and Cost Containment
1113	Convert Prepaid Mental Health to Cost for Service	Recalibrate Medicaid Benefits and Reimbursement Rates
1114	Enhanced E-Prescribing for Better Decision-Making	Eliminate Government Barriers to Quality Improvement and Cost Containment
1118	Continue Funding for Oral Health Care	Recalibrate Medicaid Benefits and Reimbursement Rates
1120	Require Hospitals to Fully Integrate Pharmacists into Staffing	Recalibrate Medicaid Benefits and Reimbursement Rates
1127	Consolidate the Medicaid Dental Program and use State-of- the Art Management Technology	Eliminate Government Barriers to Quality Improvement and Cost Containment
1140	Maintain Funding for Facilitated Enrollment	Ensure Consumer Protection and Promote Personal Responsibility
1142	Replace State-operated System With Private Treatment Centers	Recalibrate Medicaid Benefits and Reimbursement Rates
1143	Allow CBO´s to "Piggy-Back" on OGS Vendor Contracts	Eliminate Government Barriers to Quality Improvement and Cost Containment
1144	Eliminate County/Municipal Duplication of Service	Eliminate Government Barriers to Quality Improvement and Cost Containment
1146	No Increase in Drug Treatment Capacities	Recalibrate Medicaid Benefits and Reimbursement Rates
1147	Juvenile Justice Reform	Recalibrate Medicaid Benefits and Reimbursement Rates
1169	Explore computer programs	None
1193	Adopt a 85% Medical Loss Ratio for Medicaid Managed Care Programs	Recalibrate Medicaid Benefits and Reimbursement Rates
1201	Include registered dietitians as providers	Recalibrate Medicaid Benefits and Reimbursement Rates
1222	New service links	Eliminate Government Barriers to Quality Improvement and Cost Containment
1230	Convene a workgroup for regulatory reforms	Eliminate Government Barriers to Quality Improvement and Cost Containment
1252	Require MCOs to obtain NCQA Accreditation	Ensure That Every Medicaid Member is Enrolled in Care Management
1273	Assisted Living Program (ALP) Redesign Proposal	Empower Patients and Rebalance Service Delivery
1281	Establish Disease Management Programs	Empower Patients and Rebalance Service Delivery
1283	Negotiated Rates for Nursing Homes	Recalibrate Medicaid Benefits and Reimbursement Rates
1286	Do Not Implement Regional Pricing for Nursing Homes	Recalibrate Medicaid Benefits and Reimbursement Rates
1297	Expansion of Federally Qualified Health Centers (FQHC) as health homes	Empower Patients and Rebalance Service Delivery
1299	Inpatient Detox Services	Recalibrate Medicaid Benefits and Reimbursement Rates
1304	Allow home care/personal care consumers to bank/save authorized hours	Ensure Consumer Protection and Promote Personal Responsibility
1310	Higher Reimbursement Rates for Home Care Private Duty Nursing	Recalibrate Medicaid Benefits and Reimbursement Rates
1348	Improve Private Duty Nursing Benefit	Eliminate Government Barriers to Quality Improvement and Cost Containment
1358	Convert prepaid MH services to cost for services	Recalibrate Medicaid Benefits and Reimbursement Rates
1368	Restore funding for Alzheimer´s Coalition Chapters	Empower Patients and Rebalance Service Delivery
1374	ACA Implementation- Early Implementation of Medicaid Expansion	Better align Medicaid with Medicare and ACA
1377	Develop Standards for Home Health Aide Utilization.	Eliminate Fraud and Abuse
1383	Increase Medicaid fee schedule amounts for psychiatry	Better align Medicaid with Medicare and ACA
1395	Recover Overpayments Resulting From Erroneous MCO Cost Reports	Eliminate Fraud and Abuse
1397	Recover Medicaid Payments From Network Providers in Cases of Fraud	Eliminate Fraud and Abuse
1422	Redesign Long Term Care Services	Empower Patients and Rebalance Service Delivery
1426	Hospice Outreach	Empower Patients and Rebalance Service Delivery
1439	Restructure Alcoholism Treatment Centers	Recalibrate Medicaid Benefits and Reimbursement Rates
1454	Modify the Case Mix Medicaid Nursing Home System to Encourage Quality, Access, Efficiency	Recalibrate Medicaid Benefits and Reimbursement Rates
1456	Medicaid LTC Buy-In Program	Ensure Consumer Protection and Promote Personal Responsibility
4617	Enhance community support to maintain senior citizens in their homes	Not Assigned
4620	Expand Home and Community–Based Services	Not Assigned
4621	Increase Physician Fee Schedule Rates	Recalibrate Medicaid Benefits and Reimbursement Rates
4633	Broaden HIV Special Needs Plans benefits and convert home-based services programs to managed long-term care plans	Ensure That Every Medicaid Member is Enrolled in Care Management
4634	Decrease Use of General Hospitals for Detox	Recalibrate Medicaid Benefits and Reimbursement Rates
4637	Multiple approaches to reduce indoor air pollution as a means of reducing respiratory inflammation and in turn ED, urgent care and	None
4639	Expand Medicaid case management to include licensed therapists/social worker or medical partner/nurse to assist with short term therapeutic	Empower Patients and Rebalance Service Delivery
4640	Multiple including: reduce recertification process to 1 or 2 times annually, additional physician training for HIV/AIDS treatment,	Empower Patients and Rebalance Service Delivery
4641	Preserve New York´s Regional Training Centers for HIV/AIDS	Eliminate Government Barriers to Quality Improvement and Cost Containment
4643	Reform of the EI program by requiring that commercial insurers provide coverage for all services that counties deem medically necessary	Recalibrate Medicaid Benefits and Reimbursement Rates
4650	Establish "special needs plans" (SNPs) to manage care for those with SMI/SUDS	Recalibrate Medicaid Benefits and Reimbursement Rates