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There are 163 item(s) tagged with the keyword "Medicaid Redesign".
- Displaying: 111 - 120 of 163
- 111. MLTC Policy 13.20: Provision of DME Supplies through Pharmacy
- August 12, 2013
DOH has issued a policy update regarding an on-going review of Pharmacy claims which determined that certain Durable Medical Equipment (DME) items were being inappropriately billed as a Pharmacy claim. These billing errors resulted in a fee-for-service payment of items that are included in the capitation payment to Managed Long Term Care Plans (MLTCP).
- 112. MLTC Policy 13.19: Medicare/Medicaid Coordination of Benefits
- July 23, 2013
The purpose of this policy document is to remind Managed Long Term Care (MLTC) plans of the need to effectively coordinate Medicare and other third-party liability benefits for the MLTC dual-eligible membership. Federal regulations require Medicaid to be the payer of last resort.
- 113. Level 1 Personal Care Services and Consumer Directed Personal Assistance Services in Managed Long Term Care
- July 23, 2013
This GIS further clarifies MLTC policies as it pertains to Level 1 personal care services as the sole community-based long term care service provided to a consumer.
- 114. Transitioning from the LTHHCP to MLTC
- July 2, 2013
LeadingAge NY continues to advocate for answers and clarification as this mandatory transition from the LTHHCP to MLTC begins.
- 115. MLTC Policy 13.18: MLTC Guidance on Hospice Coverage
- June 25, 2013
DOH has posted a policy on utilizing hospice while in MLTC pursuant to recent changes to Section 4403-f of Article 44 of PHL.
- 116. Nursing Home Managed Care Transition Questioned
- June 18, 2013
At a June 17 DOH work group meeting, LeadingAge NY and other stakeholders raised questions about the timing and financial aspects of the state’s plan to move certain nursing home residents into Medicaid managed care.
- 117. DOH Posts Three New MLTC Policies
- June 17, 2013
DOH has posted two policies on defining community based long term care services and one on Care Management Administrative Services (CMAS) agreement guidelines.
- 118. MLTC Policy 13.15: Refining the Definition of Community Based Long Term Care Services
- June 11, 2013
The MLTC policy 13:15 further clarifies the definition of community based long term care by stating individuals who only require assistance with housekeeping tasks do not meet the intent of community based long term care services.
- 119. MLTC Policy 13.16: Questions and Answers Further Clarifying the Definition of Community Based Long Term Care Services
- June 11, 2013
Another MLTC policy further refining the definition of Community Based Long Term Care Services as it relates to Consumer Directed Personal Assistance Program and discrete housekeeping services.
- 120. MLTC 13.14: Questions Regarding Managed Long Term Care (MLTC) Eligibility
- June 10, 2013
The purpose of this policy is to further clarify programmatic eligibility for enrollment in managed long term care plans. Some MLTC plans have sought greater clarification from the Department as a result of the request to review the use of social day care services for their enrollees.
- Displaying: 111 - 120 of 163