Plan Association Data Request on New York Independent Assessor (NYIA) Implementation Survey

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* 2. For what percentage of consumers did NYIA complete the initial assessment (CHA and CA) within 14 calendar days? To ensure consistent reporting across plans, please use the scheduled CHA date as the start of the 14-day timeframe. If your plan is unable to report this data, please put N/A.

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* 3. MLTC/MAP Plans Only: What percentage of prospective consumers experienced delayed enrollment due to NYIA’s inability to complete initial assessments (CHA and CA) within 14 calendar days? If your plan is unable to report this data, please put N/A.

Optional: If your plan tracks the level of information listed below, please click here to download an Excel spreadsheet template and share this information with Manatt to provide more insight on delayed enrollment. Please email the completed table to Ben Ahmad at BAhmad@manatt.com.

Date Case was Received by Plan
NYIA CHA Completion Date
NYIA CA Scheduled Date
Age Between Date Case was Received & CA
Original Expected Enrollment Date (based on date case was received)
New Likely (or Actual) Enrollment Date

CHA Variance Process

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* 4. How many variance requests did your plan submit to NYIA between 8/20/22 and 9/20/22? If your plan is unable to report this data, please put N/A.

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* 5. How many CHAs were upheld in this process? If your plan is unable to report this data, please put N/A.

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* 6. How many CHAs were overturned? If your plan is unable to report this data, please put N/A.

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* 7. What are the top three most common factual variances that your plan identifies in NYIA’s CHAs? Please select three choices below.

Identification Information

Intake/Initial History

Cognition

Communication and Vision

Mood and Behavior

Psychosocial Well-Being

Functional Status

Continence

Disease Diagnoses

Health Conditions

Oral and Nutritional Status

Medications and Allergies

Treatments and Procedures

Social Supports

Environmental Assessment

Skin Conditions

Responsibility

Mental Health Service History

Mental State Indicators

Substance Use

Harm to Self and Others

Stress and Trauma

Social Relations

Unable to Report

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* 8. Please provide any poignant examples of instances in which a factual variance(s) could have impacted or did impact the consumer’s plan of care. Please include a CIN, where possible or appropriate, and provide as much detail as possible.

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* 9. What are the top three most common clinical variances that your plan identifies in NYIA’s CHAs? Please select three choices below.

Identification Information

Intake/Initial History

Cognition

Communication and Vision

Mood and Behavior

Psychosocial Well-Being

Functional Status

Continence

Disease Diagnoses

Health Conditions

Oral and Nutritional Status

Medications and Allergies

Treatments and Procedures

Social Supports

Environmental Assessment

Skin Conditions

Responsibility

Mental Health Service History

Mental State Indicators

Substance Use

Harm to Self and Others

Stress and Trauma

Social Relations

Unable to Report

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* 10. Please provide any poignant examples of instances in which a clinical variance(s) could have impacted or did impact the consumer’s plan of care. Please include a CIN, where possible or appropriate, and provide as much detail as possible.

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* 11. What was the average turnaround time from your submission of a variance request to receipt of a determination from NYIA? Please select one option below.

1-3 days

3-6 days

6-9 days

10+ days

Unable to report

Other/Poignant Examples

For each of the below scenarios (questions 12-16), please indicate how frequently your plan is experiencing the issue and provide any poignant examples. When providing examples, please include CIN information, as applicable, and provide as much detail as possible.

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* 12. MLTC/MAP Plans Only: The consumer experienced issues with the eligibility determination process as a result of NYIA.

Very often

Somewhat often

Not very often

Never/not yet

Example(s):

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* 13. Our plan has identified conflicting information between the CHA and CA.

Very often

Somewhat often

Not very often

Never/not yet

Example(s):

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* 14. The consumer had difficulty getting an in-person CHA or CA even after requesting one.

Very often

Somewhat often

Not very often

Never/not yet

Example(s):

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* 15. The NYIA nurse assessor did not show up for the CHA or CA appointment (nurse assessor “no-show”).

Very often

Somewhat often

Not very often

Never/not yet

Example(s):

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* 16. The NYIA representative provided incorrect information to the consumer and/or the plan.

Very often

Somewhat often

Not very often

Never/not yet

Example(s):

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* 17. What trends, if any, is your plan seeing in the quality of assessments completed by NYIA? Please share any analysis, findings or examples to support this. For example, do you have any information on the differences in assessments conducted by your plan and NYIA that may impact care planning or consumer access to care? Please be sure to include a CIN and provide as much detail as possible.

Workforce Impact

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* 18. Has your plan lost nurses to the NYIA between 8/20– 9/20? If yes, please enter the approximate percentage of nurses lost during this period.

Yes

Unable to Report

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* 1. Plan Name (For Internal Purposes Only)

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* 2. For what percentage of consumers did NYIA complete the initial assessment (CHA and CA) within 14 calendar days? To ensure consistent reporting across plans, please use the scheduled CHA date as the start of the 14-day timeframe. If your plan is unable to report this data, please put N/A.

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* 3. MLTC/MAP Plans Only: What percentage of prospective consumers experienced delayed enrollment due to NYIA’s inability to complete initial assessments (CHA and CA) within 14 calendar days? If your plan is unable to report this data, please put N/A.

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* 4. How many variance requests did your plan submit to NYIA between 8/20/22 and 9/20/22? If your plan is unable to report this data, please put N/A.

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* 5. How many CHAs were upheld in this process? If your plan is unable to report this data, please put N/A.

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* 6. How many CHAs were overturned? If your plan is unable to report this data, please put N/A.

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* 7. What are the top three most common factual variances that your plan identifies in NYIA’s CHAs? Please select three choices below.

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* 8. Please provide any poignant examples of instances in which a factual variance(s) could have impacted or did impact the consumer’s plan of care. Please include a CIN, where possible or appropriate, and provide as much detail as possible.

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* 9. What are the top three most common clinical variances that your plan identifies in NYIA’s CHAs? Please select three choices below.

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* 10. Please provide any poignant examples of instances in which a clinical variance(s) could have impacted or did impact the consumer’s plan of care. Please include a CIN, where possible or appropriate, and provide as much detail as possible.

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* 11. What was the average turnaround time from your submission of a variance request to receipt of a determination from NYIA? Please select one option below.

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* 12. MLTC/MAP Plans Only: The consumer experienced issues with the eligibility determination process as a result of NYIA.

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* 13. Our plan has identified conflicting information between the CHA and CA.

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* 14. The consumer had difficulty getting an in-person CHA or CA even after requesting one.

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* 15. The NYIA nurse assessor did not show up for the CHA or CA appointment (nurse assessor “no-show”).

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* 16. The NYIA representative provided incorrect information to the consumer and/or the plan.

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* 18. Has your plan lost nurses to the NYIA between 8/20– 9/20? If yes, please enter the approximate percentage of nurses lost during this period.