Medicaid Nursing Home Care: More Winds of Change

January 1, 2014
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In March of 2014 New York State will begin to implement a plan to incorporate nursing homes in to the Managed Long-term Care Program (MLTC). This process will take around two years and will not affect any one who is already residing in a nursing home. Those already receiving nursing home care will continue to have that care paid for by Medicaid in the traditional fee-for-service method in which Medicaid pays the nursing home directly and the Medicaid beneficiary is free to choose any nursing home. This will also not affect those who pay out-of-pocket or with any other form of insurance except for Medicaid. The major change under the MLTC plan is that Medicaid recipients who plan to enter a nursing home will now have to join an MLTC insurance plan. In this model, they will have to choose from certain nursing homes that are on the plan they decide to join. Despite the new limit on choices, the MLTC program will also have positive aspects including that the nursing home standards are expected to be more closely monitored therefore ensuring a higher quality of care. These changes will take time to implement and we do not expect significant changes to occur quickly but we will continue to provide updates as we learn of them.

For those who are wondering how to best choose a plan, the Long Term Care Community Coalition (LTCCC) recently did a study and ranked current MLTC programs, which can be found at the following: To read the LTCCC’s full article about the MLTC change please visit: – the article begins on page one and then continues on pages 4 and 5.

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