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

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.

The US Dept. of Health & Human Services (HHS) has proposed a "sunset regulation" that would retroactively impose a mandatory expiration date on an estimated 18,000 duly promulgated regulations for programs ranging from Medicaid and Medicare to the FDA and CDC. NYLAG submitted comments on these rules.

This advocacy memo from NYLAG explains the rules regarding treatment of pre-paid funeral agreements for burial arrangements for Medicaid eligibility for people age 65+, blind, or disabled.

NYLAG PowerPoint presentation explaining the Medicare Part D program, with changes for the 2021 calendar year. The annual enrollment period for 2021 began Oct. 15, 20 and goes thru Dec. 7, 2020.

Benchmark Part D plans in NYS 2021 - Free Premiums for People with Extra Help/ Low Income Subsidy - Seven plans will be free for those with full Extra Help. Two plans that were benchmark in 2020 are closing in 2021. This fact sheet explains how members of those plans can ensure full access to covered prescriptions in 2021.

NYLAG Comments filed on Sept. 8, 2020 on Proposed Changes to State Regulations for Medicaid Managed Care Appeals and Fair Hearings. The proposed amendments implement the "exhaustion" requirements implemented in NYS in 2018, implementing federal changes adopted in 2016.

NYLAG COMMENTS on Proposed Regulations implementing the Medicaid Home Care Changes - Eligibility and Assessment Procedures enacted in the 2020-21 NYS Budget. The proposed regulations are posted here - https://regs.health.ny.gov/sites/default/files/proposed-regulations/Personal%20Care%20Services%20and%20Consumer%20Directed%20Personal%20Assistance%20Program.pdf

NYLAG Comments on Proposed Changes in 1115 Waiver Governing MLTC to Impose "LOOKBACK" for Communiity Based Long Term Care. The waiver document is posted here https://health.ny.gov/health_care/medicaid/redesign/mrt2/proposals/mltc_elig_vol_enroll_duals.htm

Webinar presentation by Valerie Bogart, EFLRP, NYLAG, presented on Sept. 9, 2020 on upcoming changes in Medicaid - a new lookback for community based long term care services, new ADL requirements on eligibiliity for personal care and CDPAP, and new assessments for all home care in MLTC, managed care and local Medicaid offices