Implementation of Conflict-Free Evaluation for MLTC
The Department of Health (DOH) has released MLTC Policy 14.06: Implementation of the Conflict-Free Evaluation and Enrollment Center (CFEEC), dated Sept. 30, 2014. The purpose of the policy is to inform Managed Long Term Care Plans (MLTCPs) of the process for implementing the new CFEEC. For more background on the CFEEC, please refer to the DOH September 2014 Medicaid Update. For LeadingAge NY comments and analysis, please click here.
The CFEEC is effective Oct. 1, 2014 in Region 1 (Bronx and Manhattan). Under CFEEC, MLTCPs will no longer be permitted to enroll individuals until Maximus (New York Medicaid Choice) has conducted an evaluation to determine if the individual is eligible for Community-Based Long Term Care (CBLTC) services. DOH held a teleconference on the new CFEEC on Sept. 22 and the slide presentation and recording, along with other materials, are available as follows:
9.22.14 CFEEC Recorded session
DOH projects the statewide phase-in of the CFEEC by region as follows:
Region 1 – October 2014: New York (Manhattan) & Bronx
Region 2 – November 2014: Kings (Brooklyn), Queens, Nassau, & Richmond (Staten Island)
Region 3 – February 2015: Westchester & Suffolk
Region 4 - March 2015:
- East Hudson (Columbia, Dutchess, Putnam)
- Catskill (Rockland, Orange, Ulster, Greene, Sullivan)
- Capital (Warren, Washington, Saratoga, Fulton, Montgomery, Schoharie, Schenectady, Albany, Rensselaer)
- Other (Erie, Monroe, Onondaga)
Region 5 – April 2015:
- Southern Tier (Tompkins, Cortland, Tioga, Broome, Chenango, Otsego, Delaware)
- Finger Lakes (Wayne, Ontario, Livingston, Seneca, Cayuga, Yates, Schuyler, Chemung, Steuben)
- Western (Chautauqua, Cattaraugus, Allegany, Wyoming, Genesee, Orleans, Niagara)
Region 6 – May 2015:
- Central (Jefferson, Oswego, Lewis, Oneida, Herkimer, Madison)
- Northern (St. Lawrence, Franklin, Clinton, Essex, Hamilton)
Once the CFEEC is implemented in a given region, no new referrals may be accepted by MLTCPs unless the enrollment process had begun prior to the implementation date. Once implemented in a region, MLTC plans receiving calls from Medicaid recipients seeking a plan assessment for enrollment must be directed to the CFEEC at 1-855-222-8350. MLTCPs should be modifying language in the marketing materials to reflect the CFEEC evaluation and enrollment process. This policy applies to all MLTC products (Partial Cap, PACE, MAP, and FIDA).
Questions on the CFEEC enrollment and evaluation process should be directed to DOH at CF.Evaluation.Center@health.ny.gov.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827