MLTC to FFS Transition Update

Carl J. Pucci in Finance & Reimbursement

DOH will be conducting a second “Batch Process” disenrollment to continue implementation of the MLTC to FFS transition process. DOH is requesting that providers transmit a listing of residents who are designated L-T Nursing Home Stay (LTNHS), are enrolled in an MLTC plan, and who have an active discharge plan to transition to the community. The list must be submitted to DOH no later than Monday, September 21, 2020.

This additional batch process will disenroll residents now meeting the above criteria that were not included in the initial 8/1/20 disenrollment. These newly disenrolled members will be converted to Medicaid FFS, effective November 1, 2020. Attached is the DOH DAL with further information.  Also attached below are supporting file documents to be utilized in support of the resident listing to be provided to DOH. 

Questions should be emailed to DOH.SM.MLTCNH@health.ny.gov.

NYSHFA/NYSCAL CONTACTS:

Carl J. Pucci
Chief Financial Officer
518-462-4800 x36