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
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
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
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
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
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
RegulationsElectronic 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
RegulationsDOH Webinar Reviews SADC Site Evaluation Tool
Tool and accompanying guide were developed by DOH to assist MLTC plans in verifying that network SADC sites are compliant with state and federal requirements.
- September 20, 2022
RegulationsLeadingAge NY Seeks Delay in Implementation and Added Flexibility in Comments on Proposed OMIG Regs
LeadingAge NY's comments also requested that PACE programs be exempt from managed care provisions of the proposed regulations.
- September 12, 2022
RegulationsCMS Unveils Tools to Improve State and Federal Oversight of Medicaid Managed Care Plans
The tools include an update on the web-based portal for state reports on managed care; two additional state reporting templates related to MLR and network adequacy and access assurances; a new technical assistance toolkit for states to oversee access in MLTC programs; and recommended practices for ensuring timely and accurate payment to Indian health care providers.
- July 12, 2022
- view more