N.Y. Medicaid Hospice Program Manual Policy Guidelines, Section II, Managed Long Term Care

The Managed Long Term Care (MLTC) program, which includes Partial Capitation,

Medicaid Advantage Plus (MAP), and Program for All-Inclusive Care for the Elderly

(PACE), provides long term services and supports to hospice electees in different ways.

Individuals enrolled in the Medicaid fee-for-service program and elect hospice are not

eligible to enroll in MLTC and would remain under the Medicaid fee-for-service program

(per diem reimbursement) for the duration of their approved hospice services.

Individuals enrolled in the MLTC program who decide to elect hospice can remain

enrolled in the Partial Capitation, MAP, and Fully Integrated Duals Advantage for

Individuals with Intellectual and Developmental Disabilities (FIDA-IDD). Individuals

enrolled in PACE are not eligible for hospice, because PACE plans have an alternate

end of life program. If the individual would rather a hospice program, they must be

disenrolled from PACE prior to enrollment in hospice.

Information on hospice coverage for children under age 21 can be found at:

DOH Medicaid Update January 2011 Vol. 27, No. 1, Office of Health Insurance Programs

(ny.gov)

Information on hospice coverage in Partial Capitation and MAP can be found at:

https://www.health.ny.gov/health_care/medicaid/redesign/2015-12-

31_hospice_mltc_faq.htm

Information on hospice coverage in PACE can be found at:

https://www.health.ny.gov/health_care/medicaid/redesign/mltc_policy_13-18.htm

Information on FIDA-IDD can be found at:

https://opwdd.ny.gov/location/partners-health-planfida-idd

Hospice regulations can be found at:

https://regs.health.ny.gov/content/article-9-hospice-operation