MLTC Implementation Advisory Group Update

DOH discussed two new MLTC policy documents during the most recent MLTC Implementation Advisory Group conference call:

MLTC policy 13.10 announces an extension of the continuity of care policy from 60 days to 90 days. Effective May 8, 2013, each enrollee who is receiving services must continue to receive those services under the enrollee's pre-exisiting service plan for at least 90 days after enrollment, or until a care assessment has been completed by the plan, whichever is later. In addition, the recipient/worker relationship must be preserved for the same 90 day period.

MLTC policy 13.11 covers social adult day care services through a questions and answers format.  This policy clarifies the Department's recent directives concerning soical adult day care services and MLTC, including issues addressed in the April 26, 2013 letter to MLTC plans from Jason Helgerson.

DOH also shared that they are finalizing the special terms and conditions for Long Term Home Health Care Programs (LTHHCP) that permit the mandatory enrollment of the LTHHCP patients into MLTC.  DOH is awaiting final approval from CMS. Once CMS approval is recievced DOH has stated that they will provide education and guidance on the special terms and conditions and how this will impact the LTHHCP. 

Finally, DOH confirmed that the MLTC enrollment package for dual-eligible LTHHCP participants will be mailed shortly in all mandatory counties. Medicaid-only LTHHCP participants will receive the enrollment package around the same time.

Contact: Anne Hill, ahill@leadingageny.org, 518-867-8836