GIS 14 MA/021:Implementation of the Conflict Free Evaluation and Enrollment Center

To:All Local District Commissioners, Medicaid Directors, Supervisors of Long Term Care Services

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

Subject: Implementation of the Conflict Free Evaluation and Enrollment Center

Effective Date:Immediately

Contact Person: Bureau of Managed Long Term Care Staff
(518) 474-6965 or CF.Evaluation.Center@health.ny.gov

The purpose of this directive is to inform local districts of a change in the enrollment process for individuals seeking Community Based Long Term Care (CBLTC) services. This policy does not apply to individuals transferring from one plan to another or from one MLTC product to another.

Beginning October 1, 2014, the Department will begin implementation of the Conflict-Free Evaluation and Enrollment Center (CFEEC). Managed Long Term Care Plans (MLTCP) will no longer be permitted to enroll individuals until Maximus (New York Medicaid Choice) has conducted an evaluation determining if the individual is CBLTC eligible. The Department has established a system, in cooperation with Maximus, that all new MLTCP enrollees must have a Uniform Assessment System (UAS) on record prior to enrollment. The Department will develop a system edit to prevent individuals from enrolling into a plan without an UAS conducted by Maximus on file first.

No new referrals may be accepted by plans effective October 1, 2014. If the plan has made contact with the consumer prior to October 1, the MLTCP may continue with enrollment activities. Local district staff or MLTC plans receiving calls from Medicaid recipients seeking a plan assessment for enrollment must be directed to the CFEEC at 1-855-222-8350 when it becomes operational in your district.

For more information, please visit the Department's Medicaid Redesign website at: http://www.health.ny.gov/health_care/medicaid/redesign/mrt_90.htm.

If you have any questions regarding this information, please email to the following address:
CF.Evaluation.Center@health.ny.gov

This directive is effective in accordance with the tentative implementation schedule enclosed.

CFEEC Implementation Timeline

Region/Month Counties
Region 1 - October 2014 New York & Bronx
Region 2 - November 2014 Kings, Queens, Nassau & Richmond
Region 3 - February 2015 Westchester & Suffolk
Region 4 - March 2015 East Hudson (Columbia, Dutchess, Putman),
Catskill (Rockland, Orange, Ulster, Greene, Sullivan),
Capital (Warren, Washington, Saratoga, Fulton,
Montgomery, Schoharie, Schenectady, Albany,
Rensselaer), and
Other (Erie, Monroe, Onondaga)
Region 5 - April 2015 Southern Tier (Tompkins, Cortland, Tioga, Broome,
Chenango, Otsego, Delaware)
Finger Lakes (Wayne, Ontario, Livingston, Seneca,
Cayuga, Yates, Schuyler, Chemung, Steuben)
Western (Chautauqua, Cattaraugus, Allegany,
Wyoming, Genesee, Orleans, Niagara)
Region 6 - May 2015 Central (Jefferson, Oswego, Lewis, Oneida, Herkimer,
Madison)
Northern (St. Lawrence, Franklin, Clinton, Essex,
Hamilton)