Managed Long Term Care Plans Reminded to Contract with Social Care Networks

(Feb. 18, 2025) The Department of Health (DOH) reminded Managed Long Term Care (MLTC) plans last week of their obligation to contract with all Social Care Network (SCN) lead entities within their operating regions and to comply with the “MCO Policy Paper” regarding their role and responsibilities in relation to the SCNs. Under the NY Health Equity Reform (NYHER) Medicaid Waiver, the nine SCNs are responsible for coordinating screenings of Medicaid beneficiaries for health-related social needs (HRSN), referring individuals to HRSN services, and managing payments to network providers that conduct the screenings and deliver the HRSN services. For qualified MLTC beneficiaries, HRSN services include transportation, personal safety interventions, housing supports, and case management. MLTC plans and other Medicaid managed care plans provide the SCN lead entities with a per member per month amount, submit data to the SCNs regarding plan members who may be eligible for enhanced HRSN services, and inform their members about available SCN services.

The MCO Policy Paper (MLTC Policy 25.02) is available here. Information for providers about SCNs is available here. More information from LeadingAge NY about the NYHER Waiver and the SCNs is available here. Questions may be submitted to DOH here.

Contact: Karen Lipson, klipson@leadingageny.org