DOH Clarifies MLTC Dispute Resolution and Health Information Release Policies

The Department of Health has issued two Managed Long Term Care (MLTC) policy documents updating previously issued policies. MLTC Policy 13.24(a) updates guidance on Authorization for Release of Protected Health Information forms that Partial MLTC, MAP and PACE plans must use for new enrollees. MLTC Policy 16.03 provides additional clarification to MLTC plans that the dispute resolution process is used in cases where there are eligibility disagreements between the plan and the Conflict Free Evaluation and Enrollment Center, but not when the plan denies enrollment for reasons such as health and safety concerns.  

Policy 13.24(a) is here while 16.03 (which updates Policy 15.08) is here.  

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841