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New York’s 2012 Managed Long Term Care Report: An Incomplete Picture

April 8, 2013

 

The Coalition to Protect the Rights of New York’s Dually Eligible is a coalition of consumer advocates focused on protecting the rights of some of the most vulnerable in our communities – elderly or disabled Medicare recipients who also meet the income threshold for Medicaid, also referred to as the dually eligible.  Currently, this population is being enrolled into Managed Long Term Care (MLTC) in New York City, Long Island, and Westchester with expansion planned upstate. Additionally in 2014, contingent on Federal approval, this same population will be enrolled into new health insurance plans that provide dually eligible New Yorkers with their Medicare and Medicaid benefits. As such it is critical to ensure that private health plan performance metrics are collected by the State, analyzed and distilled by the State, and presented to dually eligible beneficiaries so they are able to make informed choices about their health care.  

To this end, the State Legislature enacted a reporting requirement to ensure that MLTC plans provide required services and that consumers have the information they need to make meaningful choices between plans. Specifically, Section 4403-f(7)(b)(vii)of the Public Health Law requires the Commissioner of Health to issue biannual reports on enrollee satisfaction, service utilization, enrollment data, quality data, and continuity of care. The reports must be published on the New York State Department of Health’s (the Department’s) website and formatted to allow consumers to make comparisons between plans.   

Although the Department recently released the 2012 Managed Long Term Care Report (2012 MLTC Report)  we believe it does not provide the full spectrum of information that beneficiaries need to make informed health care choices.

Click here to read the report.