DOH Releases MLTC to FFS Transition Guidance

Carl Pucci and Allison Gold in Finance & Reimbursement

DOH has released a DAL, “Changes in Enrollment into MLTCP and Benefit Announcement” letter outlining the transition from MLTC to FFS, as originally announced in last week’s DOH Monthly Update.

Following CMS’ approval to limit the nursing home MLTCP Plan Benefit to three months for long-term nursing home stays (LTNHS), DOH is requiring the following:

Providers must transmit a list of all residents who are designated as long-term nursing home stays (LTNHS), are enrolled in an MLTCP Plan, and have an active discharge plan to transition to the community to DOH no later than January 28, 2020.

The list should include the following:

  • Name of nursing home
  • Facility contact (name, telephone, email)
  • Transitioning residents name
  • CIN (Client Identification Number)
  • Date of LTNHS designation
  • Name of resident’s MLTCP Plan 

The list of residents with an active discharge plan must be transmitted through the HCS using MLTC Nursing Home shared mailbox by 1/28/20. 

Questions should be emailed to MLTCNH@health.ny.gov. Please also cc the NYSHFA contacts below as NYSHFA will accumulate member questions and concerns for DOH feedback throughout the FFS transition process.

NYSHFA/NYSCAL CONTACTS:

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

Allie Gold, Esq.
Director of Policy & Reimbursement
518-462-4800 x25