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Medicaid Redesign

Medicaid Redesign

MLTC Policy 13.19: Medicare/Medicaid Coordination of Benefits

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.

11 years ago

Medicaid Redesign

Transitioning from the LTHHCP to MLTC

LeadingAge NY continues to advocate for answers and clarification as this mandatory transition from the LTHHCP to MLTC begins.

11 years ago

Medicaid Redesign

Nursing Home Managed Care Transition Questioned

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.

11 years ago

Medicaid Redesign

MLTC Policy 13.15: Refining the Definition of Community Based Long Term Care Services

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.

11 years ago

Medicaid Redesign

Level 1 Personal Care Services and Consumer Directed Personal Assistance Services in Managed Long Term Care

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.

11 years ago

Medicaid Redesign

MLTC Policy 13.18: MLTC Guidance on Hospice Coverage

DOH has posted a policy on utilizing hospice while in MLTC pursuant to recent changes to Section 4403-f of Article 44 of PHL.

11 years ago

Medicaid Redesign

DOH Posts Three New MLTC Policies

DOH has posted two policies on defining community based long term care services and one on Care Management Administrative Services (CMAS) agreement guidelines. 

11 years ago

Medicaid Redesign

MLTC Policy 13.16: Questions and Answers Further Clarifying the Definition of Community Based Long Term Care Services

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. 

11 years ago
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