The New York State (NYS) Department of Health (DOH) has released new guidance that places a limit on the number of Licensed Home Care Service Agencies (LHCSAs) that a partially-capitated managed long-term care (MLTC) plan may contract with in its network. DOH was required to publish this guidance by provisions in the NYS Fiscal Year 2018-19 Enacted Budget.
The guidance takes into account two factors to establish a plan-specific maximum number of contracted LHCSAs: (1) the plan’s service region (Downstate or Rest of State), and (2) the number of plan enrollees in the region. All MLTC plans must come into compliance with these limits by October 1st. The statute does not limit the number of enrollees that a LHCSA may serve.
The Contract Limitation Guidance is available here. A summary of the guidance is attached.