Consumer Advocacy and Financial Alignment Demonstrations Health Action 2014 Krystal Knight New York State Policy Director.

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Presentation transcript:

Consumer Advocacy and Financial Alignment Demonstrations Health Action 2014 Krystal Knight New York State Policy Director

© 2013 Medicare Rights Center Medicare Rights Center  The Medicare Rights Center is a national, not- for-profit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through: Counseling and advocacy Educational programs Public policy initiatives

© 2013 Medicare Rights Center The Coalition  Coalition to Protect the Rights of New York’s Dually Eligible (CPRNYDE)  Made up of over 45 consumer advocacy organizations  Steering Committee: Medicare Rights Center Empire Justice Center New York Legal Assistance Group Center for Independence of the Disabled, New York Legal Aid Society New York Association of Independent Living Community Service Society Consumer Directed Personal Assistance Association of New York State

© 2013 Medicare Rights Center Fully Integrated Dual Advantage (FIDA)  170,000 duals receiving 120 days or more of long term care in the community or SNF  Capitated model  Geographic area: New York City, Long Island, Westchester  Phased enrollment: Voluntary beginning October 1st 2014, Passive beginning January 1 st 2015  MOU signed August 2014  Readiness Review began October 2014

© 2013 Medicare Rights Center Policy Priorities  Core Areas of Focus Enrollment Network adequacy Plan payment and performance measures Stakeholder and beneficiary engagement Appeals and grievance procedures Monitoring and oversight Participant Ombudsman ADA compliance

© 2013 Medicare Rights Center Advocacy “WINS”  Integrated Appeals  Aid Continuing / Aid Paid Pending  Readiness Review  Interdisciplinary Team

© 2013 Medicare Rights Center Krystal Knight