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Annual Review of Managed Care Exemption and Exclusion Codes Required

The state Department of Health (DOH) has posted a General Information System (GIS) message to advise local departments of social services (LDSS) that an annual review of managed care exemption (91) and exclusion (90) Restrictive/Exception (R/E) entered codes should take place.

With most Medicaid populations transitioning into mandatory managed care, DOH stresses the importance of placing an end date on 90/91 R/E codes to avoid impeding managed care enrollment.

The GIS is at http://www.health.ny.gov/health_care/medicaid/publications/pub2015gis.htm (see GIS 15 MA/012).