DOH Activates Additional Involuntary Disenrollment Reason
(Sept. 17, 2024) On Sept. 3rd, the Department of Health (DOH) released Managed Long Term Care (MLTC) Policy 24.02, Update to Resumption of MLTC Involuntary Disenrollments, applicable to Partial Capitation and Medicaid Advantage Plus (MAP) plans and Programs of All-Inclusive Care for the Elderly (PACE). The policy resumes an additional mandatory involuntary disenrollment reason: enrollee refused to cooperate or was unable to be reached to complete the required assessment. In addition, DOH released an updated Intent to Disenroll Template.
MLTC Policy 24.02 is posted here; the updated Intent to Disenroll Template was emailed to plans. The policy updates and replaces MLTC Policy 23.03, Resumption of MLTC Involuntary Disenrollment Guidance, issued last year on Oct. 19, 2023. Completed evidence packets may be submitted to NY Medicaid Choice (NYMC) for this new reason beginning Oct. 3, 2024 for Nov. 1, 2024 effective dates.
DOH urges plans to review the instructions in MLTC Policy 24.02 closely to ensure compliance with the MLTC contractual requirements for this newly added, as well as the previously resumed, involuntary disenrollment reasons. The Frequently Asked Questions (FAQ) document related to previously released MLTC Policy 23.03 is available here. DOH is fielding questions at mltcinfo@health.ny.gov.
LeadingAge NY Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841