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Operations and Marketing

Operations and Marketing

DOH Posts PHE Unwinding Questions and Answers

Document addresses wide array of questions on the resumption of eligibility redeterminations for Medicaid and other programs.

July 18, 2023

Operations and Marketing

Health Care Coverage During the Unwind

NY Health Foundation to offer session titled Keeping New Yorkers Covered as Pandemic-era Provisions Wind Down on May 10th.

May 9, 2023

Operations and Marketing

Medicaid Recertification Webinar Available on Demand

OMH/DOH session aimed at behavioral health providers, managed care plans, care managers, and others is available for on-demand viewing on the MCTAC site.

May 2, 2023

Operations and Marketing

VBP Measures for PACE and MAP Plans to Resume in 2023

DOH had suspended its calculation of value-based payment measures as a result of the COVID-19 pandemic. It resumed calculation of the Potentially Avoidable Hospitalization measure in measurement year 2021 and will calculate all Category 1 measures for PACE and MAP plans for 2023.

January 10, 2023

Operations and Marketing

Roll-Back of Independent Assessment Process Sought by LeadingAge NY, Other Advocates

In a letter to DOH, the associations and consumer advocates requested suspension of independent clinical assessments and a delay in the launch of independent 'immediate need' and 'expedited' initial assessments and independent reassessments, in light of scheduling, customer service, and accuracy concerns.

November 1, 2022

Operations and Marketing

Department Shares Further Guidance on Disenrollments

DOH provides update on the resumption of additional MLTC involuntary disenrollment reason, No CBLTSS, and announces an educational webinar.

May 3, 2022

Operations and Marketing

LeadingAge NY Asks Governor to Retract MLTC Competitive Procurement Proposal

LeadingAge NY wrote to Governor Hochul seeking a 30-day amendment to the Executive Budget that withdraws the proposal to competitively procure Medicaid MLTC contracts. The letter pointed out the importance of preserving consumer choice and access to the expertise of specialized plans sponsored by non-profit LTC providers. Our action alert for LTC providers is here.

February 1, 2022

Operations and Marketing

DFS 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 Marketing

DOH 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 Marketing

DOH Distributes MLTC Quality Incentive Methodology

The 2020 measures and scoring will remain largely consistent with prior years.

December 31, 2019
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