DOH Provides Update on Managed Long Term Care Implementation

The New York State Department of Health provided an update on managed long term care implementation during a conference call with stakeholders. The Department reiterated that mandatory enrollment in managed long term care had commenced in four upstate counties: Albany, Erie, Monroe and Onondaga. Beneficiaries requiring more than 120 days of community-based long term care services are being transitioned into managed care plans.

The Department anticipates that, excluding beneficiaries receiving long term CHHA services, an additional 3,300 beneficiaries will be mandated to enroll in managed care plans in the four counties. The Department defines a "long term CHHA case" as one in which Medicaid has been billed for four consecutive cycles. Although notices concerning mandatory enrollment have been sent to long term CHHA beneficiaries, the Department did not know how many beneficiaries are in this category. 

The Department reminded managed care plans using care management administrative services agreements that they are required to comply with the guidelines and new protocols issued on Oct. 18, and to submit to the Department either revised protocols or an attestation that previously-approved protocols comply with the new protocols within 60 days of Oct. 18. Plans that had submitted contracts or contract amendments to the Department for review prior to Oct. 18 are required to submit revised contracts by Dec. 31 to comply with the guidelines. The care management administrative services agreement guidelines are available here.

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