Lance's Corner

NYSDOH Issues New MOLST Form

May 2, 2025

Per the notice below, the New York State Department of Health (NYSDOH) has issued a new Medical Orders for Life-Sustaining Treatment (MOLST) form.  While dentists cannot execute or change MOLST documents, they may encounter them as part of a patient's medical history.

New York State Department of Health Announces Revision of Medical Orders for Life-Sustaining Treatment (MOLST) Form

MOLST Form Records Patients' Preferences for Life-Sustaining Treatments

Revision a Collaboration of Multiple Agencies

The New York State Department of Health announced the revision of the Medical Orders for Life-Sustaining Treatment (MOLST) Form, a form that records a patient's preferences for life-sustaining treatments, such as CPR, ventilation, and other interventions, to ensure all patients are considered.  The comprehensive revision was a collaboration of the Department, New York State Office for People with Developmental Disabilities (OPWDD), the New York State Office of Mental Health (OMH), and the MOLST Statewide Implementation Committee.  Additionally, Excellus updated the electronic form (eMOLST) to match the newly released paper form.  While Excellus is no longer accepting new applications to their eMOLST registry where the electronic MOLST is currently located, healthcare providers with an existing eMOLST agreement will be able to continue using the registry.  Previous versions of the MOLST paper and electronic forms are still valid if patients present with an older version of the medical order.

"The release of the revised Medical Orders for Life-Sustaining Treatment forms and eMOLST are important because they ensure that a patient's current medical condition, values, and treatment preferences are communicated and respected across all healthcare settings," State Health Commissioner Dr. James McDonald said.  "I thank everyone involved in this revision and who is committed to confirming patients' current health status is reflected, their wishes are honored, and unwanted or inappropriate interventions are prevented."

"The release of a revised MOLST and eMOLST has been an important part of our foundational work as a Center for Hospice & Palliative Care," State Health Department Center for Hospice & Palliative Care Director Kara Travis said.  "While we are charged with increasing awareness and access to end-of-life care options as well as Advance Care Planning, making sure there is a consistent, collaborative, patient-centered conversation happening at the bedside or in living rooms across the care continuum will always be a critical component of our mission to encourage all New Yorkers to live their best life as they age or combat chronic illness."

"Emergency medical services personnel, home care services agency personnel, hospice personnel, and hospital emergency services personnel are required to honor nonhospital Do Not Resuscitate and Do Not Intubate orders that are issued using the MOLST form," State Health Department Division of Legal Affair Attorney Jonathan Karmel, Esq said.  "The MOLST form, instructions, and additional guidance materials will ensure that physicians, nurse practitioners, and physician assistants issue end-of-life medical orders to withhold or withdraw life-sustaining treatment in accordance with their patients' wishes."

"End-of-Life preferences are very personal decisions and come at the hardest time for a family," State Office for People with Developmental Disabilities Acting Commissioner Willow Baer said.  "Updates to the MOLST form and its instructions provide more detailed explanations and choices regarding end-of-life care, making it easier to provide dignity for and choice by people with developmental disabilities, together with their families and loved ones.  OPWDD appreciates the working partnership between the NYS Department of Health and Office for Mental Health to further develop and clarify this vital legal document for the people we support."

Office of Mental Health Commissioner Dr. Ann Sullivan said, "OMH was pleased to partner with DOH on the revisions of the MOLST and the eMOLST forms.  The MOLST and eMOLST forms provide that patients choices about their care are readily and easily available across treatment settings, ensuring their wishes are respected."

All information regarding the MOLST, including the form, supporting checklists, glossary, and instructions are available on the NYSDOH Center for Hospice & Palliative Care's webpage.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc