This Vital Information email is one in a series of communications to keep you up to date on issues important
to the practice of pediatrics in New York State.
| In This Bulletin |
| Medicaid Payment Rule |
| Vaccine Safety…If Your Office Lost Power |
| Children’s Emotional Responses to Sandy |
| Medicaid/Medicare Payment Rule |
| NCQA Level One Payment |
| Update on NYS Exchange |
Update Medicaid Payment Rule Implementation in New York State 2/22/2013
New York State has not yet chosen exactly how it will process the Medicaid Payment Rule. But almost all pediatricians who see Medicaid patients will be eligible for the increased payments retroactive to January 1, 2013. Once New York State makes its final decision about the procedure, you will be informed.
The information that you received from the National AAP is not relevant to New York State at this time.
There is nothing you need to do right now, and you will not be disadvantaged in any way.
How Best to Secure Your Vaccine Supply & Ordering Replacement Vaccines (VFC and Commercial)
Details and specific instructions from the NYSDOH and the NYC DOHMH are available in these two formal communications:
Children’s Emotional Responses to Sandy
Many children lost their homes, parts of their neighborhoods and are attending different schools. They are dealing with high levels of stress from parents and other family members. Many are in shelters, or have been stuck in their own apartments or houses without heat or electricity for more than a week. Even children not directly in the path of the storm have been exposed to frightening media reports. You may see the results of these emotional stressors in the children you care for.
Here are some resources available to help you help your child patients respond to fears and anxieties brought on by Superstorm Sandy:
- http://nysaap.org/child-and-adolescent-psychiatry-for-primary-care/ – CAP PC (Child and Adolescent Psychiatry for Primary Care)
- http://www2.aap.org/disasters/toolkit.cfm – “Feelings Need Check Ups Too”
Medicaid/Medicare Payment Rule
Now that the election is over and President Obama has been re-elected we know that the Medicaid/Medicare Payment Rule will be implemented. CMS, the federal agency working on Medicaid and Medicare, has issued its final rule. NYS is now actively planning for the design and implementation of the increased payments to pediatricians.
Your AAP District II (NYS) representatives are meeting with State Department of Health senior staff to provide input into the state’s planning. Our goal is to help design a simple, transparent process to get dollars from the federal government into the hands of primary care pediatricians.
For more information, please see the following documents:
- CMS Finalizes ACA Medicaid Payment Increase Rule (written by the National AAP)
- Medicaid Primary Care Rate Increase Final Rule: Fast Facts (written by the Center for Health Care Strategies, Inc.)
On January 1, 2013, New York State’s Medicaid program will no longer offer incentive payments to practices that have attained NCQA Level One. The State will continue payments to practices that are working toward or that attain Levels Two and Three.
The State defines its expectations in this letter to all physicians:
With the election over, NYS is moving full steam ahead with the implementation of its Health Insurance Exchange. The State has demonstrated the proposed internet universal portal to the State Exchange Advisory. It is apparent that New Yorkers will be purchasing insurance by internet within the next 12 months. It is imperative that you talk with your families about how to maintain their relationship with you as they are faced with various options to purchase insurance for themselves and their children.
If you need more information on any of the above issues, feel free to contact, Elie Ward, Director Policy & Advocacy, AAP District II (NYS), at eward@aap.net