Changes in federal Medicaid regulations will take effect in New York State May 1, 2018. These changes affect over 4.7 million New Yorkers -- all members of Medicaid Managed Long Term Care (MLTC) Plans and “mainstream” Medicaid managed care plans. If the managed care or MLTC plan denies or reduces a service after May 1, 2018, the member will be required to request an internal “Plan Appeal” first, and wait for the plan’s decision, before they request a Fair Hearing with the NYS Office of Temporary & Disability Assistance. In other words, they are required to “exhaust” the internal plan appeal before requesting a fair hearing. See more info about the new rule here -- http://www.wnylc.com/health/entry/184/.

The CLE will explain the new rule and its limited exceptions, and the new appeal process. It will also cover the new requirements for the plan member to “authorize” a representative to request a plan appeal or a fair hearing.

WHO: The CLE is sponsored for lawyer, paralegals, and other professionals working or volunteering in the non-profit sector, including social workers who assist seniors and people with disabilities in accessing Medicaid services.

CLE: The New York Legal Assistance Group has been certified as an Accredited Provider of Continuing Legal Education. 1.5 Professional Practice credits and .5 Skills credits have been authorized for this session. This course is appropriate for both newly admitted and experienced attorneys. CLE credit will not be available for future viewing of the recorded webinar.

COST: Free for those working in or doing pro bono work for a non-profit legal services, advocacy, or social services organization. Private lawyers and geriatric care managers are asked for a suggested donation of $75 per session

Announces change effective April 23, 2017 from LogistiCare to MAS - Medical Answering Services LLC, the same contractor handling much of upstate NYS.

This outline describes the evaluation process for someone who is on Medicare and Medicaid (approved or application pending) who requires enrollment into a Managed Long Term Care plan. Revised 12-2016 to include change that CFEEC now valid for 75 instead of 60 days.

Mailing from New York Medicaid Choice to MLTC Members in FIDA Demo Area (New York City and Nassau County) explaining FIDA program. May be confusing to members who previously opted out of FIDA.

Comments to last in series of proposed regulations implementing 2015 law requiring expedited processing of Medicaid apps in 7 days where there is an immediate need for personal care or CDPAP. Regs published for comment March 2, 2016.

HRA alert replacing MAP 751d with OCA 960 effective immediately.

Testimony of NYLAG to the New York State Legislature Joint Hearing of the Senate Finance and Assembly Ways and Means Committees - January 2016

Official training PowerPoint for MLTC and Managed care plans, nursing homes and NYC Medicaid staff on submission of Medicaid applications for nursing home care under new 2015 changes requiring permanent nursing home residents to enroll in or stay in managed care or mLTC plans. October 2015.