Implementation of MLTC Nursing Home Benefit Change Delayed
Following recent approval by the Centers for Medicare and Medicaid Services (CMS), the Department of Health (DOH) is in the process of implementing the three-month enrollment limitation for long-stay nursing home residents who are enrolled in a partially capitated Managed Long Term Care (MLTC) plan. Outside of New York City (NYC), MLTC members living in nursing homes who have met the three-month long-stay threshold had been scheduled to be disenrolled from MLTC and revert to fee-for service (FFS) Medicaid on March 1st. Due to a systems problem identified late last week, the March 1st transition from MLTC to FFS will NOT occur as scheduled.
We are awaiting additional information regarding the magnitude of the problem from DOH, who promised to share the new transition date when established.
Please note that the DOH announcement impacted the scheduled March 1st non-NYC transition. It is not clear whether the situation will delay the NYC transition originally scheduled for April 1st.
We will share any new information with members as soon as it becomes available. In the meantime, we urge member providers and plans to let us know of any concerns or problems that they encounter (or foresee) as part of this transition.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841