NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC
Non-Profit
Advocacy 8-5-21 Letter to CMS with Concerns re NYS Spending Plan for Federal HCBS Funding Download
NYS HCBS eFMAP plan consumer advocate CMS ltr 8.5.21 final.pdf
Letter sent by NYLAG, Medicaid Matters NY, Legal Aid Society, Empire Justice Center and other NYS advocacy organizations to CMS dated Aug. 5, 2021. Expresses concerns about the NYS plan for spending billions of enhanced federal Medicaid dollars available under the American Rescue Plan Act of 2021 (ARPA) that must be used for enhancing access to Home & Community Based Services (HCBS). NYS Spending Plan and other info about this funding is at https://www.health.ny.gov/health_care/medicaid/redesign/hcbs/enhanced_funding/.
13 Sep, 2021 427 kb Downloads: 1221
Health Plan Appeal Rights in New York After the Affordable Care Act Download
Appeals Paper final with 2021 updates - CSS.pdf
Article from the New York State Bar Association Health Law Journal about the impact of Federal health reform on appeal rights under private health insurance plans. By Samuel Salganik, Community Health Advocates (CHA). Community Service Society of New York, NYSBA Health Law Journal |Winter 2012 |Vol. 17 |No. 1

THis version includes 2021 updates on pages 32 and 37.
13 Aug, 2021 125 kb Downloads: 21589
Know your Rights: Tips for Requesting New or Increased Services from a Medicaid Managed Care or MLTC Plan Download
Requesting Services from an MCO 2021.pdf
Fact Sheet prepared by the NYLAG Evelyn Frank Legal Resources Program explaining tips on how to request new or increased services from a Medicaid managed care or MLTC plan, including the timeline in which the plan must process the increase. Russian translation posted at http://www.wnylc.com/health/download/782/

If the request is denied, see separate Fact sheet on appealing denials. http://www.wnylc.com/health/download/654/.
03 Aug, 2021 360 kb Downloads: 4151
Know your Rights: Tips for Requesting New or Increased Services from a Medicaid Managed Care or MLTC Plan (RUSSIAN) Download
Requesting Services from an MCO - 2021 Russian Translation.pdf
Russian Translation of Fact Sheet prepared by the NYLAG Evelyn Frank Legal Resources Program explaining tips on how to request new or increased services from a Medicaid managed care or MLTC plan, including the timeline in which the plan must process the increase. English version is at http://www.wnylc.com/health/download/723/

If the request is denied, see separate Fact sheet on appealing denials. http://www.wnylc.com/health/download/654/
03 Aug, 2021 659 kb Downloads: 1369
Medicare Special Needs Plans - NYS 2021 Download
2021 NYS Special Needs Plan Landscape with insulin with INTEGRATED status as of 7-2021.xls
Medicare Special Needs Plans - NYS 2021 - lists compiled from CMS lists. Includes plans in new federal program to cover insulinat $35 per month supply, and for DUAL-SNPS (D-SNPS) indicates if plan is "FIDE" or "HIDE" fully-integrated plans integrating Medicare and Medicaid, some with integrated appeals. These fully integrated plans are also known as Medicaid Advantage Plus (MAP).. See this article http://www.wnylc.com/health/entry/225/ about integrated appeals for MAP plans.
18 Jul, 2021 321 kb Downloads: 2133
NYLAG Comments on How State Proposes to Implement the "Lookback" for Community -Based Long Term Care Services Download
NYLAG Comments to CMS 5-6-2021 1115 Waiver Lookback.pdf
Comments filed on May 5, 2021 in response to the State Dept. of Health's proposal to CMS on how it will implemenet the 30-month Lookback, that was enacted in the NYS FY 20-21 Budget, and applies to MLTC enrollment and all other home care and the Assisted Living Program. The State's proposal can be viewed at https://health.ny.gov/health_care/medicaid/redesign/mrt2/proposals/30-month_lookback-final.htm
16 May, 2021 820 kb Downloads: 1527
NYLAG & Other Advocates Call For NYS Budget to Ensure Access to Community Based Long Term Care Services Download
Consumer Advocate Letter re Community based LTC NYS 21-22 Budget.2.pdf
Letter to Governor Cuomo and leaders of the legislature calling for NYS Budget initiatives that will ensure access to home care to prevent unnecessary institutionalization -- COVID-19 has been a wake-up call for the need to avoid nursing home placement when ever possible.
26 Mar, 2021 638 kb Downloads: 1574
NYLAG COMMENTS on Proposed Home Care Regulation Changes - Eligibility and Assessment Procedures Download
NYLAG Comments 505.14 - 505.28 3-13-21 with NYSBA copy.pdf
NYLAG's comments submitted on the 2nd round of proposed State regulations implementing 2020 changes in State law restricting eligibility for personal care, CDPAP and MLTC enrollment, and changing the procedures for how Medicaid home care services are assessed. The proposed State reg can be found at https://health.ny.gov/health_care/medicaid/redesign/mrt2/express_terms_summary.htm. The NYSBA Elder Law & Special Needs Section comments are also attached to and referenced in the NYLAG comments.
19 Mar, 2021 1.28 mb Downloads: 2590
NYLAG Comments on Proposed Changes in 1115 Waiver - ADL Limits for MLTC and Staying in Medicaid Managed Care when Enroll in Medicare Download
NYLAG CMS comments 1115 Waiver NYS 12-24-20.pdf
NYS DOH has requested that CMS change the 1115 waiver that governs MLTC and managed care in 2 ways. (1) Restrict enrollment in MLTC to those meeting new 2- or 3- ADL requirement enacted in State budget in April 2020; (2) Keep people in mainstream Medicaid managed care plans when they start getting Medicare, if they are enrolled in a Dual-Special Needs Plan. They could opt out but otherwise would automatically stay in managed care. See waiver request at https://content.govdelivery.com/accounts/USCMSMEDICAID/bulletins/2aea7cd. NYLAG comments posted here
24 Dec, 2020 1012 kb Downloads: 1513
NYLAG Comments on Medicaid State Plan Amendment to Implement the ADL Restrictions on Eligibility for Personal Care & CDPAP Download
NYLAG COMMENTS SPA -PCS CDPAP.pdf
Comments filed by NYLAG dated Oct. 29, 2020 on the proposed Medicaid State Plan Amendment (SPA) that would restrict elgibility for personal care and CDPAP services to require 2 or 3 ADL needs. The proposed SPA No. 20-41 was posted September 29, 2020 and is available at https://www.health.ny.gov/regulations/state_plans/status/ltcare/original/docs/os_2020-09-29_spa_20-41.pdf.
24 Dec, 2020 841 kb Downloads: 1445
Prev Next
1 2 3 4 5 6 7 8 9 10


This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.