CMS Approved the Move of LTHHCP Participants to MLTC

On April 2, DOH announced that CMS has approved the amendment to New York’s Medicaid section 1115 allowing the transition of patients from the Long Term Home Health Care Program (LTHHCP) into Managed Long Term Care (MLTC) and Mainstream Medicaid Managed Care (MMC) plans. This approval letter also clarifies that two additional waiver services, medical social services and home delivered meals, will be added to the managed care benefit so that they can continue to be offered by the LTHHCP population. 

DOH also received notice from CMS approving the 1915 (c) wavier amendment for the LTHHCP. This means “beginning April 1, 2013 all Medicaid recipients, age 21 and over, in need of certain community-based long term care services for over 120 days – including the LTHHCP waiver participants will be required to enroll into a MLTC, this will begin statewide April 2013. For the non-duals who reside in counties without MLTC capacity they will be offered to stay in the LTHHCP or transfer to another 1915 (c) waiver program that contains the same level of services available to participants in the LTHHCP.”

According to DOH, transition activities will start in April 2013 for dual eligibles over the age of 21 in NYC, Nassau, Suffolk and Westchester counties.

LeadingAge NY has been seeking additional clarification from both DOH and CMS regarding the transition timeline and process.  We participated in a Medicaid Managed Care Advisory Review Panel (MMCARP) conference call on April 3 and were informed that new participants to the LTHHCP can still be enrolled. It was implied that until all the details are finalized on the Special Terms and Conditions (STCs) between DOH and CMS, that business will continue as usual.

LeadingAge NY will keep members informed as additional information becomes available.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8383 ext. 151