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DOH Issues CFCO Guidelines

The first of several documents that the Department of Health (DOH) intends to issue on the implementation of the Community First Choice Option (CFCO) details the role and responsibilities of Managed Long Term Care (MLTC) plans and describes the services and supports encompassed by the program. The "Guidelines for the Provision of Services Under the Community First Choice Option Benefit Within Managed Long Term Care" are dated Dec. 6th and can be accessed here. They apply to MLTC Partial Capitation plans, Medicaid Advantage Plus (MAP) plans, and Programs of All Inclusive Care for the Elderly (PACE). FIDA plans already include a majority of CFCO services in the benefit package; services that are not included will be clarified/identified in future guidance. DOH has issued a separate guidance document for mainstream Medicaid managed care plans.

The guideline document identifies those services and supports currently in the MLTC benefit package that are eligible for CFCO claiming and lists and describes the new services that are being added through CFCO. Plans will need to submit network provider listings as part of the readiness review process and will be required to contract with at least two providers for each service in every county, where available. CFCO is scheduled to be implemented starting July 1, 2017.

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