HCP Expresses Concerns to DOH about GuildNet and Elderplan Transition Plans

Last week, HCP sent a letter to the New York State Department of Health (DOH) Office of Health Insurance Programs (OHIP) expressing concerns on managed long term care (MLTC) plans exiting the downstate region. The letter, addressed to Andrew Segal, Director, Division of Long Term Care, specifically discusses mounting concerns with GuildNet, which notified providers and plan enrollees that it will end its MLTC services in Nassau, Suffolk, and Westchester counties as of June 1, as well as Elderplan/HomeFirst, which recently notified its enrollees in Suffolk County that its MLTC services will end on July 1.

HCP has closely monitored the situation with GuildNet since the plan initially announced it would stop taking new cases in the aforementioned counties late last year. In a meeting with DOH in December 2016, HCP was assured that GuildNet had not been approved to stop its enrollment or issue a letter stating so. DOH further clarified that MLTC plans cannot stop new enrollments in a county and would instead need to be approved to completely withdraw from the county. DOH would not provide any new information to HCP during an in-person meeting in mid-March (HCP Insider, 3/17/17), and has not responded to numerous requests from HCP for confirmation that GuildNet has been approved to transition out of Nassau, Suffolk, and Westchester counties.

Given the media whirlwind that ensued following GuildNet’s initial announcement, HCP has sought confirmation from DOH to ensure that accurate information is being relayed to the home care provider community and to their consumers. In addition to requesting such confirmation, HCP’s letter requests the Department’s transition plan for GuildNet’s and Elderplan’s withdrawal from these counties.

Read the full article in the March 31, 2017 issue of the HCP Insider.

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