New York FIDA-IDD Quality Withhold Measures for 2025 Announced
Relevant to: State Medicare-Medicaid Plan Handbooks
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.
Click here to read the complete memo from CMS.
Introduction
The Centers for Medicare & Medicaid Services have released the New York FIDA-IDD-specific quality withhold technical notes for demonstration years 2 through 9. This release is part of the ongoing Medicare-Medicaid Financial Alignment Initiative, aimed at improving care through a capitated model demonstration. The notes provide crucial details and benchmarks for state-specific quality withhold measures, tailored specifically for the New York FIDA-IDD Plan. Covering an additional demonstration year for 2025, these technical notes serve to enhance the implementation of the financial alignment initiative.
Key Dates and Deadlines
- Date of Memo: January 16, 2025
- Demonstration Years Covered: Years 2 through 9
- Additional Year Covered: 2025 (Demonstration Year 9)
PACE Compliance
This memo holds significance for PACE programs through its connection with the Medicare-Medicaid Financial Alignment Initiative, influencing how compliance measures are evaluated for New York’s FIDA-IDD demonstration years 2 through 9. It affects quality withhold measures, which serve as benchmarks for performance that plans must meet.
Plans involved must ensure compliance by adhering to these quality withhold measures, as non-compliance could impact the capitated payments or the demonstration’s outcomes. This requires meticulous tracking and meeting of specific health service metrics, thereby guaranteeing the plan’s alignment with CMS Core Quality Withhold Notes.
Consistent review and revision of compliance protocols is necessary in accordance with the CMS guidelines to accommodate any changes in the demonstration period, such as the extension to 2025 noted in the memo. Ensuring adherence to these benchmarks is vital in maintaining compliance and securing the necessary funding and operational approvals under these demonstrations.
Required Actions
The purpose of this memorandum is to announce the release of the Demonstration Years (DY) 2 through 9 state-specific quality withhold technical notes for the New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) Demonstration, a capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative. The document provides additional details and benchmarks for the statespecific quality withhold measures that the New York FIDA-IDD Plan is responsible for under the demonstration. These state-specific measures directly supplement the Medicare-Medicaid Capitated Financial Alignment Model CMS Core Quality Withhold Technical Notes for DY 2 through 12. CMS and the state revised the New York FIDA-IDD quality withhold technical notes to cover the additional demonstration year for 2025 (DY 9). Please contact the Medicare-Medicaid Coordination Office at mmcocapsmodel@cms.hhs.gov if you have any questions.
FAQs
- “What are the New York FIDA-IDD specific quality withhold technical notes?”
- “How does the New York FIDA-IDD Plan measure quality withholds for the demonstration years?”
- “What changes were made to the FIDA-IDD quality withhold technical notes for 2025?”
- “How do these notes relate to the Medicare-Medicaid Capitated Financial Alignment Model core notes?”
- “Who should I contact for further questions about the quality withhold notes?”