Requirements for Nursing Facility Authorizations Beyond 90 Days

Nursing facilities are responsible for timely completing and submitting all documentation required for Medicaid long-term placement determinations, including obtaining Institutional Medicaid Approval and applicable Level-of-Care determinations, in accordance with Department of Health (DOH) and Local Department of Social Services (LDSS) requirements.

Facilities may be required to provide proof of State submission and other supporting documentation upon request. Failure to comply with policy requirements may affect authorization extensions beyond the initial 90-day period and could impact payment.

Action Required: Review the Custodial Nursing Facility Placement (Medicaid) Policy to understand documentation, authorization, and compliance requirements.

Submit required custodial care documentation to [email protected], including applicable proof of State submission and other documentation required under the policy.

This Policy will become effective thirty (30) days from the date of this notice, unless a different notice period is required under the applicable Provider Agreement, in which case the Policy will become effective upon expiration of that required notice period.

Questions? Contact Provider Services: (866) 783-0222.