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Regulations

Regulations

DOH Activates Additional Involuntary Disenrollment Reason

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

September 17, 2024

Regulations

DOH Answers Questions on CDPAP Fiscal Intermediary RFP

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

August 20, 2024

Regulations

CMS Finalizes Medicare Advantage Policy and Payment Rules

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

April 9, 2024

Regulations

MLTC Hospice Guidance Sets Forth New Procedures to Prevent Duplicate Billing

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.

June 26, 2023

Regulations

OMIG Releases Guidance on Compliance with New Regulations

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.

February 6, 2023

Regulations

OMIG Regulations Expand Compliance Program, Overpayment, and Managed Care Plan Requirements

OMIG has adopted new regulations expanding requirements governing compliance programs; strengthening Medicaid managed care plan fraud, waste, and abuse prevention programs; and codifying OMIG’s self-disclosure program for Medicaid overpayments.

January 24, 2023

Regulations

DOH Is Accepting Comments on Statewide Transition Plan for Compliance with Federal HCBS Settings Rule

Comments are due by Jan. 6, 2023.

January 3, 2023

Regulations

CMS Proposes Wide-Ranging Medicare Advantage Rule

Policy proposals for 2024 seek to streamline prior authorizations, limit certain marketing practices, and expand health equity provisions.

December 20, 2022

Regulations

Roll-Back of Independent Assessment Process Sought by LeadingAge NY, Other Advocates

In a letter to DOH, the associations and consumer advocates requested suspension of independent clinical assessments and a delay in the launch of independent 'immediate need' and 'expedited' initial assessments and independent reassessments, in light of scheduling, customer service, and accuracy concerns.

November 1, 2022

Regulations

Electronic Noticing Effective Oct. 1st

Medicaid managed care plans, including MLTCP, MAP, and PACE, are required to provide all notices electronically to members who indicate that preference.

October 11, 2022
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