MLTC Plans Asked to Submit Enrolled Nursing Home Resident Data
The Department of Health (DOH) is asking that all Managed Long Term Care (MLTC) plans, including Programs of All-Inclusive Care for the Elderly (PACE programs), submit comprehensive historical information for each permanent placement Nursing Home Transition (NHT) stay consistent with the NHT add-on amount. The data provided should encompass all valid NHT managed care enrollees from Feb. 1, 2015 to Sept. 30, 2023. Accurate and complete submissions are critical, as the State intends to use these surveys to inform components of the rate setting process, including the NHT add-on and risk scores.
DOH circulated the survey form, a multi-tab Excel workbook, to plans by email on Oct. 2nd. Plans are asked to review the instructions carefully and provide the requested data/information on the tab appropriate for their plan type. A request will not be considered complete without a signed and dated attestation (which is included in the Excel workbook). DOH recognizes that mandating enrollment of nursing home residents into managed care did not apply to PACE plans; it asks for accurate data if available.
In the distribution email, DOH outlines several common errors from prior survey cycles, noting that submissions that are not in compliance with the provided instructions will not be accepted. Because the submission will contain protected health information (PHI), plans should take necessary steps to comply with Health Insurance Portability and Accountability Act (HIPAA) regulations when transmitting this data. Please submit this data to jzs12 and eyr13 using the Secure File Transfer application on the Health Commerce System (HCS) by close of business on Oct. 10th. All submitted data will be considered final.
DOH asks plans to note the following:
- Please use the NHT survey template provided along with the email; any prior template versions will not be considered.
- Please carefully review the [Notes & Instructions] tab because there are updates to which members to include.
- No PDF files; Excel (.xlsb) only.
- Do not send password-protected files.
- Please report the eight-digit Medicaid/Member ID numbers in the Enrollee column.
- Please report the eight-digit Plan ID associated with each Enrollee in the Health Plan ID column.
- Report all dates in MM/DD/YYYY format.
- Do not include formulas and/or links in cells.
- NHT information is no longer requested for Fully Integrated Duals Advantage (FIDA); the FIDA enrollment tab has been removed from the survey template.
- Your completed file must be named as follows, or it will not be accepted:
- ?[PLAN NAME]_NHT_Data_Request_Feb2015-Sept2023.xlsb
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841