Advocacy Continues on Third Party Liability (TPL)

LeadingAge NY members report that they have received unusually burdensome requests for records in relation to the New York State Office of Medicaid Inspector General's (OMIG's) third party liability recovery efforts. OMIG has contracted with the University of Massachusetts Medical School (UMMS) to administer the Medicare Home Health Appeals Initiative. We have spoken with staff both at UMMS and OMIG about our concerns with the volume of claims requested, especially in light of the expansion of mandatory managed care enrollment, the reductions in Long Term Home Health Care Programs, and the limited availability of staff to respond to the document requests. We have reached out to our colleagues at LeadingAge national as well.

This mandate is not new and LeadingAge NY continues to advocate with the Centers for Medicare and Medicaid Services (CMS) for a long term solution. In response to the unnecessary burden now being imposed on our home care members, we have sent another letter to CMS and continue to have regular communication with OMIG.

As LeadingAge NY continues to advocate on this issue, we will keep members abreast of any developments and continue to solicit member input on this critical issue.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871