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MRT 90: Mandatory Enrollment Managed Long Term Care

2014-2015 MLTC Transition Timeline

The following table is the transition plan for moving mandatory MLTC to upstate counties. CMS has been notified of this plan and all associated enrollment activities will be starting shortly.

Conflict-Free Evaluation and Enrollment Center (CFEEC)

Send Questions and/or Comments to CFEEC e-mail: CF.Evaluation.Center@health.ny.gov

STC28 Reporting

The Bureau of MLTC designed a tool, completed by all MLTC plans, to capture information related to reduction of personal care and consumer directed services greater than 25% occurring in the time period November 2012 through April 2013 for all individuals transitioned from fee-for-services programs to Managed Long Term Care (MLTC) plans. This aligns with New York State's Special Terms and Condition #28.

All information is self reported by plans.

A summary of this information is provided in the attached table.

Policy Documents

CDPAS Final Documents

Enrollee Announcement Materials

Provider Materials

NEW Model Contracts

  • This is the Revsied Model Contract that has been approved by Centers for Medicare and Medicaid Services (CMS) for a Managed Long Term Care (MLTC) Partial Capitation plan. The Model covers the period 9/1/12 to 12/31/14, with opportunity for one additional two year period or two additional one year periods.
    Partial Capitation Contract (PDF, 514KB)
    • The Revised Model reflects changes required to comply with the CMS 1115 Waiver.  This contract will need to be further amended once the final terms and conditions are finalized per the 4/1/13 CMS 1115 Waiver approval
  • This is the Model Contract that has been approved by the Centers for Medicare and Medicaid Services (CMS) for a Medicaid Advantage Plus (MAP) plan. The Model covers the period 1/1/12 to 12/31/14, with opportunity for one additional two year period or two additional one year periods. .
    Medicaid Advantage Plus (MAP) Model Contract (PDF, 683KB, 213pg.)
  • This is the Model Contract for the Program of All-Inclusive Care for the Elderly (PACE) plan. The Model covers the period 1/1/12 to 12/31/14, with an opportunity for one additional two year period or two additional one year periods.
    PACE Model Contract (PDF, 499KB, 79pg.)
  • This is the Model Contract that has been approved by the Centers for Medicare and Medicaid Services (CMS) for the Medicaid Advantage plan. The Model covers the period 1/1/2011 to 12/31/13, with an opportunity for one additional two year period or two additional one year periods.
    Medicaid Advantage Model Contract (PDF, 885KB, 226pg.)

Federal Approval letters for Long Term Home Health Care Program (LTHHCP) into Managed Long Term Care (MLTC) and Medicaid managed care (MMC)

Miscellaneous