Operations and Marketing
Operations and MarketingDFS Suspends Certain Utilization Review Requirements
Insurance preauthorization requirements for inpatient rehabilitation after a hospital stay as well as preauthorizations for transfers between hospitals are suspended for 30 days based on a DFS Circular Letter issued Jan. 6, 2022.
- January 11, 2022
Operations and MarketingDOH Issues Information to MLTC Plans on Resuming Additional Disenrollments
Follow-up communication provides more detail on the resumption of two additional involuntary disenrollments that had been suspended during the pandemic.
- November 30, 2021
Operations and MarketingDOH Distributes MLTC Quality Incentive Methodology
The 2020 measures and scoring will remain largely consistent with prior years.
- December 31, 2019
Operations and MarketingDOH Announces Slight Changes in MLTC Plan Quality Measures
At the annual meeting of the MLTC Plan Quality Work Group, DOH announced the suspension of an encounter data compliance measure for 2019, the resumption of the ER visit quality measure for 2019, updated diagnosis codes for calculating potentially avoidable hospitalizations for 2020, and a new performance improvement plan compliance measure for 2020.
- November 11, 2019
Operations and MarketingFiscal Intermediary Workgroup Completes Work
Final meeting reviews consumer transition issues but culminating discussion is cut short.
- August 12, 2019
Operations and MarketingDOH Posts CDPAS Templates
Templates that MLTC plans are required to use when a CDPAS FI ceases to be a network provider are now available.
- August 6, 2019
Operations and MarketingDOH Seeks Comments on Draft Community First Choice Option Guidance
The draft guidance describes the authorization process and dollar caps on CFCO Community Transitional Services; Moving Assistance; Home Delivered Meals; and Skill Acquisition, Maintenance and Enhancement services.
- July 23, 2019
Operations and MarketingCDPAS FI Workgroup Discusses Quality, Selection Criteria
At the third Fiscal Intermediary Workgroup meeting, participants continued to review suggestions that stakeholders submitted to DOH.
- July 15, 2019
Operations and MarketingDOH Presents Update on MLTC Value-Based Payment Quality Measures
A measure related to emergency room utilization was restored to the list of Category 1 quality measures for MLTC plans.
- July 2, 2019
Operations and MarketingFiscal Intermediary Work Group Focuses on Best Practices and Roles of FIs
The second meeting of the Fiscal Intermediary Work Group focused on stakeholder feedback concerning best practices and the proper roles and responsibilities of fiscal intermediaries.
- July 1, 2019
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