State Issues MLTC Policy Regarding Enhanced Plan Oversight of SADCs
(Nov. 25, 2025) The NYS Department of Health (DOH) Bureau of Managed Long Term Care (MLTC) Office of Health Plan Contracting and Oversight has posted MLTC Policy 25.05: Frequently Asked Questions (FAQs), which answers questions about MLTC plan oversight of Social Adult Day Care (SADC) programs.
The FAQs provide information and guidance related to questions in the following categories:
- General Policy
- Verification of valid Certificates of Occupancy for programs
- MLTC collection of records of service delivery, including person-centered service plans and dates of plan completion and annual compliance
- Training policies, materials, and attendance logs
- Single Case Agreement – when single case or contracts are appropriate
- Quarterly filing of single case agreements
- These are not required to be submitted in the Provider Network Data System (PNDS)
- National Provider Identifier (NPI)
- Requirement for programs with multiple sites
- Proper taxonomy
- Business address could be listed as mailing address
- Validated NPI for single case agreements and included on claim/encounter data
- For program with organizational NPI, list this under "billing provider" and SADC NPI under "rendering service provider"
For questions, SADC programs and MLTC plans should email HCBSSADCSiteAssessments@health.ny.gov.
Additional information is available:
Contact: Meg Everett, meverett@leadingageny.org