NY A10176

Changes the commissioner's reporting requirement on managed long term care plan implementation from biannual to annual reports.

Requires managed long term care plans to report detailed statewide and regional service utilization data, including number and percentage of member months authorized for different hour ranges for personal care, consumer-directed personal care, private duty nursing, and home health services.

Mandates reporting of per member per month expenditures by service type (administrative costs, case management, personal care, home health, nursing facility services, etc.) with interactive format enabling plan comparisons and calculation of percentages spent on home/community-based versus institutional care.

Requires data on complaints, grievances, and appeals for each plan, including outcomes (decided wholly/partially/wholly against enrollee) broken down by service type and issue category.

Establishes metrics tracking timely access to authorized services (staffing gaps, wait times) and rebalancing from institutional to community-based care (nursing facility admission/discharge rates, re-enrollment rates), with final audited cost reports to be made available in CSV format on the department website within 30 days of completion.