GIS 14 MA/04: Expansion of Mandatory Managed Long Term Care

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director - Division of Health Reform and Health Insurance Exchange Integration

Subject: Expansion of Mandatory Managed Long Term Care

Effective Date: Immediately

Contact Person: Deborah Conley-Flora, Bureau of Managed Long Term Care
(518) 474-6965 or MLTCTRANS@health.state.ny.us

This directive is to provide Local Department of Social Services (LDSS) with information regarding the State's Medicaid Redesign Initiative (MRT#90) to transition Dual Eligible individuals, age 21 and over, requiring more than 120 days of community based long term care services (CBLTCS) to Managed Long Term Care Plans (MLTCP). CBLTCS are defined as: Home Health Care, Personal Care Services, Adult Day Health Care, Consumer Directed Personal Assistance Program, and Private Duty Nursing.

Mandatory enrollment of these individuals into MLTCP began in September 2012 in New York City, and has expanded to nine additional districts: Albany, Erie, Monroe, Nassau, Onondaga, Orange, Rockland, Suffolk, and Westchester Counties. Dual Eligibles who were in receipt of CBLTCS, along with those newly seeking those services, have been systemically transitioned to MLTCPs.

The Department has developed a plan to transition the remainder of the State throughout 2014. The plan has been submitted to CMS as a whole. While many of the districts currently have sufficient MLTCPs operational, some of the districts planned for the later portion of 2014 have plans under development.

The rollout plan is listed below. Please note that the Department, in partnership with our Enrollment Broker, New York Medicaid Choice, will begin to work with each LDSS well in advance of the target date. Education on the processes will be conducted through conference calls, on-site training where possible, along with detailed presentations of methods to establish communication and identify roles. Outreach and education sessions will also be available for providers in each district. Focused efforts should be made to identify each district's providers of personal care services, to establish linkages with MLTCPs.

2014 MLTC Transition Timeline

MonthCounties
April 1Columbia, Putnam, Sullivan, Ulster
May 1Rensselaer, Cayuga, Herkimer, Oneida
June 1Greene, Schenectady, Washington, Saratoga
July 1Dutchess, Montgomery, Broome, Fulton, Madison, Schoharie,
Oswego
August 1Warren, Delaware, Niagara, Otsego, Chenango
September 1Essex, Clinton, Franklin, Hamilton
October 1Jefferson, Lewis, St. Lawrence, Steuben, Chautauqua,
Cattaraugus, Alleghany
November 1Yates, Seneca, Schuyler, Tioga, Cortland, Chemung
December 1Genesee, Livingston, Ontario, Orleans, Tompkins, Wayne,
Wyoming

Please contact Deborah Conley-Flora in the Bureau of Managed Long Term Care at 518-474-6965 or email toMLTCTRANS@health.state.ny.us