Effective May 1^st, new federal regulations provide for different times frames and procedures for authorizations, appeals, fair hearings, and complaints.

Plans and providers are required to use DOH-approved codes for community-based long term care services starting April 1^st.

Starting in May, MLTC plans will implement new federal requirements for service requests, appeals, and complaints.

MLTC plans should be aware of the change and confirm their ability to accept the revised beneficiary identifiers.

LeadingAge NY's general counsel, Hinman Straub, has prepared a detailed review of the Office of the Medicaid Inspector General (OMIG) Work Plan for SFY 2017-18 that highlights areas of focus for managed care organization and provider audits.

DOH reminds MLTC plans to submit contracts and accompanying documentation to MLTCcontract@health.ny.gov.

New guidelines streamline review process in anticipation of growth in value-based payment arrangements. 

Policies provide additional guidance on how plans should treat specific care reductions scenarios and appropriate uses of task-based assessment tools.