At the annual meeting of the MLTC Plan Quality Work Group, DOH announced the suspension of an encounter data compliance measure for 2019, the resumption of the ER visit quality measure for 2019, updated diagnosis codes for calculating potentially avoidable hospitalizations for 2020, and a new performance improvement plan compliance measure for 2020.

Final meeting reviews consumer transition issues but culminating discussion is cut short.  

Templates that MLTC plans are required to use when a CDPAS FI ceases to be a network provider are now available.

The draft guidance describes the authorization process and dollar caps on CFCO Community Transitional Services; Moving Assistance; Home Delivered Meals; and Skill Acquisition, Maintenance and Enhancement services.

At the third Fiscal Intermediary Workgroup meeting, participants continued to review suggestions that stakeholders submitted to DOH.

A measure related to emergency room utilization was restored to the list of Category 1 quality measures for MLTC plans.

The second meeting of the Fiscal Intermediary Work Group focused on stakeholder feedback concerning best practices and the proper roles and responsibilities of fiscal intermediaries.

The Patient Attribution Files represent plan members served by specified providers for purposes of calculating performance on quality measures.