Presentation outlines the process plans must use to report provider audit activities to OMIG.

Comments provide feedback on several PACE issues, benefit flex cards, prior authorization, and more.

Member-facing materials must be submitted to the designated mailbox and be accompanied by the appropriate coversheet.

MLTC Policy 24.02 requires mandatory disenrollment for members refusing to cooperate or who are unable to be reached for assessment.

DOH also amended key RFP provisions and extended the deadline for proposals to Aug. 21st.

Both Medicare managed care final rules are being adopted largely as proposed.

MLTC Policy 23.02 notifies plans and providers of a new Recipient Restriction Code to identify Medicaid beneficiaries who have elected hospice and requires plans to obtain and incorporate the DOH Form 5778 into care plans in order to coordinate services and financial obligations with the hospice provider.

The comprehensive guidance supports implementation of newly adopted regulations and covers compliance programs; self-disclosure; and Medicaid managed care fraud, waste, and abuse prevention programs.