DOH has initiated a "batch" disenrollment from partially capitated MLTC plans for long-term nursing home residents effective Feb. 1, 2024. MLTC plans are required to notify the MLTC Technical Assistance Center of any changes in member status.
The DOH guidance arises out of budget legislation that imposes performance standards on MLTC plans, including a standard that they offer a Dual-Eligible Special Needs Plan.
Managed care plans will now be included in the State's Coordination of Benefits Agreement crossover claims process for dually eligible beneficiaries. Partially capitated MLTC plans and MAP plans must submit their COBA attachments by June 15 th .
Partially capitated MLTC plans are requested to submit updated lists by March 9 th in preparation for the disenrollment of long-term nursing home stay members.
The tool lists the new provisions of the partial capitation contract and the documentation that must be submitted by plans to DOH by May 1 st .
February 11, 2020
DOH webinar provides overview of new model contract between State and partially capitated MLTC plans, effective from 2017 through 2021.
January 14, 2020
The model would apply only to contracts between partially-capitated MLTC plans and nursing homes.
September 18, 2018
Guidance details how MLTC plans should implement the provision that becomes effective Oct. 1 st and outlines notification requirements and exceptions processes.
DOH has presented their revised vision for Level 2 VBP arrangements for partially-capitated plans and is seeking comments.
The Department of Health has cancelled its stakeholder webinar on value-based payment (VBP) for partially-capitated managed long term care (MLTC) plans that was scheduled for Fri., May 11, 2018. It will be rescheduled for a later date.