MLTC Plan SADC Provider Network Data System (PNDS) Reporting Best Practices

The purpose of this webpage is to outline best practices for Managed Long Term Care (MLTC) Medicaid Advantage Plus (MAP) and Partial Capitation plans when reporting Social Adult Day Care (SADC) contracts in the Provider Network Data Submission (PNDS) system.

Questions regarding appropriate reporting of SADC contracts in the PNDS system can be directed to: HCBSSADCSiteAssessments@health.ny.gov.

Per analysis of quarterly MLTC plan PNDS submissions, the New York State Department of Health (the Department) has identified the following common reporting issues related to the reporting of SADC contracts:

  • Duplicate Line Items
  • Outdated Contracts
  • Inaccurate SADC Demographic Information
  • Other Provider Types Reported Under SADC Service Code

Each identified reporting issue is detailed below along with related best practices for mitigating the issue and reporting accurate SADC contracting information.

Description of the Issue

This issue occurs when an MLTC plan reports an SADC more than once by adding multiple business indicators (Medicaid Advantage Plus (Map) and Managed Long Term Care Partial Capitation (MLTCP) for the same SADC on separate lines. This results in the same SADC being listed more than once in the plan’s submission.

Best Practice(s)

Each SADC contract should be reported only once. If a plan contracts with an SADC for more than one line of business, the plan should use the appropriate MAP and MLTCP indicators within the PNDS system to reflect all applicable lines of business for that single SADC contract.

Description of the Issue

This issue occurs when an MLTC plan reports inaccurate SADC demographic (name and/or address) information.

Best Practice(s)

MLTC plan staff responsible for PNDS submissions should verify that all SADC contracts being reported are active. If a contract is in a terminated status, it should not be reported in the PNDS system.

Description of the Issue

This issue occurs when an MLTC plan reports inaccurate SADC demographic (name and/or address) information.

Examples of observed issues include:

  • Typos in SADC name and/or address.
  • Failure to include Address 2 information (Apt, Ste, Fl, etc.).
  • Failure to include SADC “doing business as” (DBA) name.
Best Practice(s)

The MLTC plan should maintain an accurate and up to date record of SADC contracts which includes verified SADC demographic information. It is recommended that MLTC plans maintain regular contact with contracted SADCs to confirm the current SADC name and address.

Please follow these general rules for reporting SADC demographic information:

  • SADC Name
    • Include both the parent organization name (if applicable) along with the name under which the SADC operates (DBA name).
  • SADC Address
Description of the Issue

This issue occurs when an MLTC plan reports non-SADC contracts with the SADC service code (662). The most common example of this is:

  • Adult Day Health Care (ADHC) service code 666.
  • Alternative Care Settings (ACS) SADC service code 677.
Best Practice(s)
  • Please ensure that SADC contracts are reported with service code 662. Please refer to the PNDS Data Dictionary for appropriate service codes for other provider types.
  • MLTC Plan Policy 25.05 Enhanced MLTC Plan Oversight of Contracted SADCs was effective as of 9/8/2025 and contains the following new requirements for MLTC plans related to reporting SADC contracts. Please refer to the policy for full details:
    • Reporting SADC Site Location NPI
      • All SADCs where members receive services must obtain an organization NPI. MLTC plans must report the NPI number for the SADC location where services are rendered, not the business address or mailing address, in PNDS submissions.
    • Reporting Single Case Agreements with SADCs
      • MLTC plans must report all single-case agreements with SADCs that are not contracted network providers, on a quarterly basis.
      • This information should be submitted quarterly via email to the SADC HCBS Compliance team at HCBSSADCSiteAssessments@health.ny.gov and include the MLTC plan's assigned plan manager.
  • The Department will continue to monitor MLTC plan PNDS submissions. Failure to appropriately report SADC contracts in PNDS submissions may result in the Department issuing an SOD.