MLTC Implementation Hits Some Snags but Keeps on Going

During the brief April 25 DOH Managed Long Term Care (MLTC) Implementation Advisory Group call, the majority of the discussion related to issues in the press regarding social adult day programs. The following is a summary of the critical information shared:

• DOH is working on two new social adult day program policies which should be posted shortly on the MRT website. According to DOH, the policies will include "common sense" guidance.
• It is the responsibility of the managed care entity that has the contract with the social adult day program to visit the site and make sure the standards of the contract are upheld.

Additional updates include:

• DOH is discussing the transition to MLTC with the Local Departments of Social Services (LDSS) of Orange and Rockland counties. This will start the “creep” upstate as outlined on slide 9 - in Phase III for June 2013. DOH is discussing whether the current personal care policy provisions of paying the current rates will be extended for these counties during the transition phase.
• The draft Special Terms & Conditions (STCs) for the amendments in New York’s Medicaid Section 1115 Demonstration to approve the Long Term Home Health Care Program (LTHHCP) patients' mandatory enrollment into MLTCs will be finalized this week. DOH will hold a future call dedicated to discuss the STCs.
• Nine Care Management Agreement Services (CMAS) contracts are currently under review by DOH. It was mentioned that some CMAS agreements were not clear in the delegated roles, thus the delay.

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