« The Dual Agenda: July 9, 2015 Issue

State Highlights


MassHealth, the state’s Medicaid program, released the One Care enrollment report for June. As of June 1, the total number of enrollees is 17,702. The total number of opt-outs is 27,512.

In other news, on July 1 MassHealth hosted a public meeting to discuss the recent withdrawal  of Fallon Total Care (FTC) from the One Care demonstration. FTC will be leaving One Care as of September 30, 2015. FTC has been providing One Care coverage in Hampden, Hampshire and Worcester counties to approximately 5,475 individuals. The public meeting focused on:

New York

The July 1 edition of Health Management Associates (HMA) Weekly Roundup reported that passive enrollment in the Fully Integrated Duals Advantage program, which was suspended in June, will resume in July and August. Also reported, in response to concerns raised by participating plans, the Interdisciplinary Team policy has been revised. Revisions address the timing of IDT meetings, as well as simplifying administrative processes and sign-off.

In other news, HMA reported new developments in New York’s Managed Long-Term Care (MLTC) program. The remaining counties in upstate NY have all received CMS approval to begin implementation of the transition to a mandatory MLTC program for dual-eligible individuals requiring more than 120 days of community-based long-term care. The transition to a mandatory MLTC program began in September 2012 in New York City and has gradually expanded across the rest of the state.


Check out the third issue of UHCAN Ohio’s Geriatric Provider Advocate Update! The e-newsletter features information geared towards providers, including an article on Medicare Crossover Claims by Dr. Orson J. Austin, a geriatrician at the University of Cincinnati and one of two geriatric provider advocates for the Ohio Consumer Voice for Integrated Care Coalition.

Rhode Island

Martha Watson, Advanced Nurse Practice Manager at Miriam Hospital and Geriatric Provider Advocate for the Rhode Island Voices for Better Health project, conducted the final training session in a series of three with a group of nurse case managers at the Neighborhood Health Plan of Rhode Island (NHPRI). Covering a range of topics in care for the older adult population in the series, this session was on “Frailty.” NHPRI is currently serving the long-term care needs of dual eligibles, and is expected to be part of Rhode Island’s forthcoming dual eligible demonstration project.

In other news, the Providence Journal, published an article on June 28 featuring Maureen Maigret, consultant to the Senior Agenda Coalition of RI and the Rhode Island Voices for Better Health, and her mother, Anne Hallal. The article reports on the recent passage of legislation that will help caregivers get help at a vital moment in the care of a loved one – the transition from hospital to home. The legislation is part of a national campaign by AARP to get states to adopt its CARE (Caregiver Advise, Record and Enable) Act. Rhode Island is now among about a dozen states that have embraced it.

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