GIS 13 MA/017: Medicaid Managed Care Guarantee

To: Local District Commissioners, Medicaid Directors

From: Mark Kissinger, Director, Division of Long Term Care

Subject: Medicaid Exclusion/Restriction Codes

Effective Date: Immediately

Contact Person: Loretta Grose - 518/474-6965

The purpose of this General Information Systems (GIS) message is to provide local departments of social services (LDSSs) with an updated list of Medicaid Exclusion/Restriction Codes. Exclusion/Restriction Codes are the two-digit numerical codes that identify a recipient's program exclusions and/or restrictions.

In order to provide LDSSs with information regarding how specific Exclusion/Restriction Codes impact enrollment into Managed Long Term Care Plans (MLTCPs),the Department has developed the attached table. The "Exclusion/Restriction Codes & MLTC Plan Enrollment" document lists the two-digit Exclusion/Restriction Code, a brief description of the Exclusion/Restriction and how the Exclusion/Restriction impacts a recipient's enrollment into a MLTCP.

The descriptive table, "Exclusion/Restriction Codes & MLTC Plan Enrollment", is attached to this GIS.