New York State Department of Health Extends Timeline for Eligible Individuals to Obtain Seamless Access to Health Care Services

Department of Health and Centers for Medicare and Medicaid Services Extend FIDA Demonstration Initiative Through End of 2019

ALBANY, N.Y. (December 13, 2016) – The New York State Department of Health (NYSDOH) today announced an extension to enroll in its Fully Integrated Duals Advantage (FIDA) demonstration initiative. FIDA is an innovative approach to health care delivery that allows low income seniors and people with disabilities to obtain services covered either by Medicare or Medicaid in a "one stop shopping" style managed care plan that maximizes access to healthcare while reducing avoidable hospital admissions and nursing facility stays.

"Improving the care experience for low-income seniors and people with disabilities who are eligible for both Medicare and Medicaid is a priority for the Department," said Commissioner of Health Dr. Howard Zucker. "Outside of this demonstration, dual eligible enrollees navigate multiple sets of rules, benefits, insurance cards, and providers. Many Medicare-Medicaid enrollees have multiple or severe chronic conditions and could benefit from enhanced care coordination and better management of their health, as well as long-term support and services."

The FIDA Demonstration was originally approved to run January 1, 2015 through December 31, 2017. Last year, CMS offered states an opportunity to extend their demonstrations through December 2019, which NYSDOH has formally accepted. The FIDA Demonstration has been operating in New York City and Nassau County, and pending final review of the Medicare provider networks, NYSDOH anticipates rolling out FIDA to Suffolk and Westchester Counties in 2017. Under the FIDA demonstration, NYSDOH and the Centers for Medicare & Medicaid Services (CMS) contract with 17 Medicare-Medicaid Plans to provide a more coordinated and patient-centered experience in the delivery of health services for people covered by both Medicare and Medicaid.

FIDA fully integrates Medicare and Medicaid benefits in a way not previously available in New York State.FIDA is the only managed care program that provides all Medicare and Medicaid benefits through one managed care plan, streamlining access to services and providing better coordinated care than available through other programs. A care manager oversees all healthcare needs, including the scheduling of appointments, transportation and medications, while an interdisciplinary team of providers convenes to discuss and plan how to meet a participant's needs. The goal is to tap into all services available to a patient through either Medicare or Medicaid.

The two-year extension will allow more time to assess the impact of FIDA on quality and cost of care. The additional time will also allow NYSDOH to maximize its experience with fully integrated care while engaging stakeholders in planning for the future when the demonstration comes to an end in 2019.

For more information about FIDA, visit: