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Electronic Noticing Effective Oct. 1st

The Department of Health (DOH) has circulated and posted guidance for Medicaid managed care plans on their responsibility to notify members electronically of coverage determination, complaint, grievance, service authorization, adverse determination, or appeal processes under Public Health Law (PHL) 4408-a, PHL Article 49, and 10 NYCRR Part 98. The requirement is effective Oct. 1, 2022 and applies to Partially Capitated Managed Long Term Care (MLTCP) plans, Medicaid Advantage Plus (MAP) plans, and Programs of All-Inclusive Care for the Elderly (PACE).

The guidance document is available here and is accompanied by an updated set of Frequently Asked Questions (FAQs) (with newer updates highlighted) and a template letter that plans are required to use. 

Questions about this guidance as it pertains to MLTCP, PACE, and MAP should be referred to MLTCinfo@health.ny.gov.

LeadingAge NY Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841