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        CMS Memo 10/28/16 re FIDA Plans Not Renewing Contracts for 2017
		
			 
		
        
            NY_FIDA_Non-renewing_Contracts_closeout instructions.pdf 
            Describes procedures for how members in those 3 plans not renewing contracts will be transitioned to other FIDA plans or may choose Original Medicare and MLTC. 
         
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        02 Nov, 2016
        141 kb
        
        Downloads: 3554
        
        
        
        
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        Attestation for Immediate Need PCS and CDPAS - 16 ADM 02 Attachment
		
			 
		
        
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        04 Aug, 2016
        299 kb
        
        Downloads: 5034
        
        
        
        
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        Immediate Need for PCS and CDPAS 16 ADM 02
		
			 
		
        
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        04 Aug, 2016
        324 kb
        
        Downloads: 7277
        
        
        
        
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        2nd Notice of Passive Enrollment into HARP/Behavioral Health Organization - 8/2015
		
			 
		
        
            HP_ENG_HARP_Passive_Enrollment_Notice_From_Sister_Plan_0615_REV_A_FinalDraft_063015.pdf 
            Second form letter sent by NY Medicaid Choice to managed care members identified as eligible for Behavioral Health services, based on past usage. This is the second notice sent to people whose managed care plan has a sister behavioral health organization or HARP, in which the member will be passively enrolled because they did not choose a different HARP after receiving the first "announcement" notice (posted at http://www.wnylc.com/health/download/586/).  
In NYC notices were sent in fall 2015 for enrollment in Oct, Nov or Dec 2015. Services begin January 2016. Upstate counties later. 
         
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        06 Nov, 2015
        237 kb
        
        Downloads: 4370
        
        
        
        
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        NYS Announcement Letter Passive Enrollment into HARP Sister Plan
		
			 
		
        
            HF_ENG_HARP_Announcement_A_Passive_With_Sister_Plan_Final_08_03_2015.pdf 
            Form letter sent from NYS DOH, OMH and OASAS to managed care members identified as eligible for Behavioral Health services, based on past usage.  This is the "announcement" notice sent to people whose managed care plan has a sister behavioral health organization or HARP, in which the member will be passively enrolled unless they choose a different HARP.  
In NYC notices were sent in fall 2015 for enrollment in OCt, Nov or Dec 2015.  Services begin January 2016.  Upstate counties later. 
         
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        06 Nov, 2015
        277 kb
        
        Downloads: 4624
        
        
        
        
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        State DOH Templates for  MLTC Denials, Reductions, Terminations - effective July 1, 2015
		
			 
		
        
            New MLTC Notices of Adverse Action - June 2015.pdf 
            Combined in one PDF is March 2015 State directive to MLTC plans requiring use of new templates for notifying member of reductions, denials, and terminations of services.  Templates should be used by mid-May 2015.   PDF includes Directive plus TWO new notice templates and the state's EXAMPLES of how the two templates are used. Also included is a sample of notice that MLTC plans sent to all members in June 2015 notifying of elimination of requirement to "exhaust" internal appeals before requesting fair hearing 
         
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        25 Jun, 2015
        1.2 mb
        
        Downloads: 45495
        
        
        
        
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        Policy Change for the Start Date of the Transfer of Assets Look Back Period
		
			 
		
        
            2015-06-02 Policy Change for the Start Date of the Transfer of Assets Look Back Period.pdf 
            Effectively immediately, the review of assets is limited to the 60-month period immediately preceding the month of institutionalization and application for Medicaid. 
 
For Medicaid recipients who are institutionalized for long-term nursing home care or receiving more than 29 days of rehabilitation services, the look-back period consists of the 60 months preceding the month of institutionalization. 
         
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        02 Jun, 2015
        308 kb
        
        Downloads: 4733
        
        
        
        
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        Newborn Processing Update
		
			 
		
        
            2015-05-06 Newborn Processing Update.pdf 
            Update advised that all newborns born in 2015 submitted via the NYS automated system have been determined processed either automatically or manually 
         
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        06 May, 2015
        191 kb
        
        Downloads: 5080
        
        
        
        
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        HIPAA Compliant Authorization Form 1-2013
		
			 
		
        
            HIPAA Compliant Authorization Form 1-2013.pdf 
            HIPAA form 
         
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        13 Apr, 2015
        47 kb
        
        Downloads: 11197
        
        
        
        
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        15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical & Medical Facilities
		
			 
		
        
            15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical and Medical Facilities.pdf 
            This informational letter provides social services districts with updated charts  that represent the monthly Personal Needs Allowance, PNAs, for residents of non-medical facilities the PNAs in medical facilities. 
         
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        13 Apr, 2015
        302 kb
        
        Downloads: 3532
        
        
        
        
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