MLTC Policy Documents

  • MLTC Policy 21.06: Changes to Consumer Directed Personal Assistance Program (CDPAP) Regulations (PDF)
  • MLTC Policy 21.05 Home and Community Based Services Social Adult Day Care Site Compliance
    • HCBS SADC Fact Sheet - (Web) - (PDF) - 12.3.2021
    • Announcement: As of 3/1/2023 MLTC Plans No Longer Need to Submit SADC HCBS Self-Assessment Surveys - (PDF) - 02.28.2023
      • MLTC SADC HCBS Self-Assessment Tool - (DOCX) - Submission to DOH No Longer Required
      • All Plan Meeting slide presentation - (Web) - (PDF) - 11.16.2021.
      • HCBS SADC Site Self-Assessment Compliance Webinar - 12.9.2021
      • HCBS Compliance Assessment with Guiding Questions for MLTC plan SADC Site Assessors - (PDF) - 12.28.2021
    • HCBS SADC Compliance Requirements for MLTC Service Area Expansions and Mergers - (PDF) - 06.30.2022
    • HCBS SADC Compliance Verification FAQs - (Web) - (PDF) - 08.11.2022
    • SUGGESTED SADC SITE EVALUATION TOOL FOR MLTC PLANS - (XLSX) - (PDF) - Updated 5.31.2023
      • Guide for MLTC Plans - (PDF) - Updated 5.31.2023
      • Video Tutorials - (Web)
      • Webinar - (PDF) - Recording - (YouTube) - Transcript - (PDF) - 9.16.2022
        • FAQs - (Web) - 10.27.2022
    • Announcement 8.10.2023: The New York State (NYS) Department of Health (DOH) would like to provide the following reminders to Managed Long Term Care (MLTC) plans, regarding network contracted Social Adult Day Cares (SADCs):

      Per MLTC Policy 15.01a, all SADC sites contracted with at least one MLTC plan must certify annually with OMIG. The certification involves the SADC site attesting to compliance with Title 9 NYCRR 6654.20, which establishes minimum requirements for the administration and operation of SADC programs across NYS. All SADC sites located in the five boroughs of NYC must register with NYC Aging per Local Law 9 of 2015 and keep the NYC SADC site registration up-to-date, ensuring changes are submitted no later than the effective date of the change. MLTC plans must update their contracted SADC sites in the quarterly Provider Network Data System (PNDS) before submission and ensure all information is accurate each quarter. DOH will reach out if any discrepancies are discovered, and it is the responsibility of all MLTC plans to ensure they are accurately managing and reporting their network to DOH.
    • Announcement: Release of SADC/SADS HCBS Final Rule Compliant PCSP Template - (PDF) - 12.14.2023
      • SADC/SADS Person Centered Service Plan Template - (DOCX) - 12.14.2023
    • Webinar - 12.7.2023: Overview for MLTC Plans: SADC HCBS Compliance Process - CY2024 HCBS Reviews
      • Recording - (YouTube) - Transcript: (PDF)
      • Presentation Slides (PDF)
  • MLTC Policy 21.04: Managed Long Term Care Partial Capitation Plan Enrollment Lock-In
    • Lock-In Policy Frequently Asked Questions - (Web) - (PDF)
  • MLTC Policy 21.03: Wage Parity Compliance and Certification Guidance
    • MLTC Policy 21.03a: Wage Parity Compliance and Certification Guidance - Clarification for Managed Care Organizations
  • MLTC Policy 21.02: Implementation of Fiscal Intermediary (FI) Rate Structure
  • MLTC Policy 21.01: Transition Policies for Fiscal Intermediaries (FIs) and Consumers under the Consumer Directed Personal Assistance Program (CDPAP)
  • MLTC Policy 20.01: Transition policies for fiscal intermediaries (FIs) and consumers under the Consumer Directed Personal Assistance Program (CDPAP) - REMOVED AND REPLACED WITH MLTC POLICY 21.01.
  • MLTC Policy 20.02: Moratorium on Managed Long Term Care Partial Capitation Plans
  • MLTC Policy 20.03: Non-emergency Transportation in the Consumer Directed Personal Assistance Program
  • MLTC Policy 19.02: Clarification of Medicaid provider enrollment provisions for services provided by integrated Medicare/Medicaid Plans (Integrated Plans) through the21st Century Cures Act
  • MLTC Policy 16.08: Conflict Free Evaluation and Enrollment Center (CFEEC) Update to Expiration of Evaluations
  • MLTC Policy 16.07: Guidance on Task-based Assessment Tools for Personal Care Services and Consumer Directed Personal Assistance Services
  • MLTC Policy 16.06: Guidance on Notices Proposing to Reduce or Discontinue Personal Care Services or Consumer Directed Personal Assistance Services
  • MLTC Policy 16.05: Non-Emergent Medical Transportation Benefit in MLTC
  • MLTC Policy 16.04: Additional Supports Available through Money Follows the Person (MFP)
  • MLTC Policy 16.03: CFEEC Dispute Resolution Update
  • MLTC Policy 16.02: Statutory Changes for Consumer Directed Personal Assistance Services (CDPAS)
  • MLTC Policy 16.01: UAS-NY Assessment Requirements