PowerPoint describes the changes in Medicaid Home Care that started being rolled out Nov. 8, 2021. This PowerPoint developed before DOH launched website about Independent Assessor that starts March 1, 2022, so does not include that info posted at https://www.health.ny.gov/health_care/medicaid/redesign/nyia/. Check for more updates at http://www.wnylc.com/health/news/85/. Webinar recording will also be posted. Proposed expansion of financial eligibility for age 65+, disabled, and blind is also discussed.

12/15/22 letter sent to DOH jointly from Medicaid Matters NY and NYLAG with concerns about implementation of the Independent Assessor changes on March 1, 2022 - with no guidance or procedures yet issued let alone tested and ready, and with a lack of capacity for NY Medicaid Choice to handle the huge demand of approximately 300,000 nurse assessments and 300,000 physician/practitioner assessments a year.

Fact Sheet includes key forms (updated 12-2021)

Powerpoint with latest info - as of Oct. 20, 2021 -- on implementation of changes enacted in the NYS FY 2020-2021 budget, including the restrictions on eligibility for Personal Care services (PCS) and CDPAP services (reqiring 2-3 ADLs), the Independent Assessor procedures, and the loosened standards allowing plans to more easily reduce hours of home care after a "transition period" for certain members.

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/.

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.

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/.

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/

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.

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