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DOH Schedules Plan COBA Webinar for May 25th

The Department of Health (DOH) has distributed a packet of documents to Medicaid Managed Care Organizations, including Managed Long Term Care (MLTC) plans, that plans will be asked to complete. Federal requirements mandate that plans responsible for coordinating benefits for dually eligible beneficiaries enter into a signed agreement with the Centers for Medicare and Medicaid Services (CMS) for the coordination of benefits and participate in the automated Medicare claims crossover process.

To comply with these federal requirements, DOH is asking that all MLTC Partial Capitation plans, Mainstream, HIV Special Needs Plan (SNP), and Health and Recovery Plan (HARP) Medicaid Managed Care Organizations complete an attachment to the Coordination of Benefits Agreement (COBA) between CMS and New York State for the purpose of adjudicating the crossover Medicare claims for dually eligible beneficiaries.

The packet sent to plans includes an explanation letter, a sample COBA attachment with comments (that must be completed for each product a managed care organization offers), the Coordination of Benefits Implementation User Guide (Version 7.1, dated April 2021), and an attestation. Also included is a sample COBA attachment for review. Prepopulated COBA attachments for each line of business will be sent to plans prior to DOH's COBA webinar on May 25th.

Plans should register here for the webinar, which will be held at 2 p.m. The session will outline the steps necessary for successful implementation and answer questions. DOH requests that plans submit advance questions by May 20th to doh.sm.COBA@health.ny.gov. All COBA attachments must be completed and returned to doh.sm.COBA@health.ny.gov on or before July 1, 2021. Additional information may be found on the CMS COBA website here.

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