DOH Delays Medicaid Managed Care until 3/1/14

Carl J. Pucci in Finance & Reimbursement


At a Managed Care Transition Workgroup meeting held earlier today, DOH announced that the start date for the Medicaid Managed Care Implementation has been delayed until March 1, 2014 for downstate (NYC/LI/Westchester) and September 1, 2014 for the rest of the state.  The two-year transition period would now commence on 3/1/14.

The delay, which includes both mainstream as well as Managed Long-Term Care plans (MLTCP’s), will allow additional time for DOH to address a number of issues and concerns.  DOH will re-draft its Managed Care policy document within the next week or so, which will center on a number of key issues to be finalized, including, but not limited to: 

  • Contract provisions/standard clauses
  • Prompt pay
  • Development of SNF rate cell
  • Bedhold
  • NAMI
  • Eligibility/Enrollment
  •  Billing and payments

The benchmark FFS rate is still in development.  DOH will schedule a provider webinar to review the policy document in early December, as well as work with the associations to develop training on a number of operational issues.

Director, Finance & Reimbursement
518-462-4800 x36