New York Budget Imposes New Rules That Limit Number Of Home Care Provider Organizations In Medicaid Managed Long-Term Care Networks

New York’s 2018-2019 budget includes provisions that affect partially capitated Medicaid managed long-term care (MLTC) plans in certain areas by limiting how many licensed home care services agency (LHCSA) the MLTC plans can contract with. The provisions are intended to create cost savings.

The New York State Department of Health presented the budget provisions affecting MLTC plans in a letter to health plans issued on April 19, 2018. The budget also included provisions limiting the nursing home benefit in partially capitated MLTC plans for permanently placed enrollees, and a lock-in provision limiting mid-year enrollee transfers . . .