Regulations
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RegulationsDOH Reminds MLTC Plans of Member Material Review Process
- Member-facing materials must be submitted to the designated mailbox and be accompanied by the appropriate coversheet. 
- December 3, 2024
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RegulationsDOH 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
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RegulationsDOH 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
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RegulationsCMS Finalizes Medicare Advantage Policy and Payment Rules
- Both Medicare managed care final rules are being adopted largely as proposed. 
- April 9, 2024
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RegulationsMLTC 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
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RegulationsOMIG 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
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RegulationsOMIG 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
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RegulationsDOH Is Accepting Comments on Statewide Transition Plan for Compliance with Federal HCBS Settings Rule
- Comments are due by Jan. 6, 2023. 
- January 3, 2023
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RegulationsCMS 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
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RegulationsRoll-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
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