What’s Next with the MLTC Implementation?

February 19, 2013

On the Feb. 14 MLTC implementation advisory call, DOH confirmed there still has not been any approval
from CMS to stop the enrollment into the LTHHCP in the counties where mandatory enrollment has
started. DOH consistently anticipates receiving approval in the future, but the LTHHCP is still a viable
program that can enroll participants in all counties.

Other new announcements:

• Approximately 3,000 long term CHHA cases in New York City, Nassau, Suffolk and Westchester will start to receive the initial “mandatory announcement letters” by the end of February. DOH did clarify they are unaware of how many long term CHHA cases there are because of the lag time in submitting claims.
• “Mandatory announcement letters” to Private Duty Nursing (PDN) cases will not be sent until sometime in March 2013.
• DOH did clarify if someone was receiving only Social Adult Day services does not meet the threshold of over 120 days of community-based long term care services for mandatory enrollment into a MLTC. DOH will be providing more guidance shortly.
• Questions remain within the DOH of whether the “Continuity of Care” policy will be extended beyond March for New York City and whether the policy can be expanded to Nassau, Suffolk and Westchester.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871