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Medicaid Managed Care
NYLAG Memo in Support of MLTC Data Transparency Bill A10176 / S9266 Download
NYLAG MEMO IN SUPPORT A10176 S9266 MLTC Data Transparency CORRECTED.pdf
NYLAG's Memo in support of bill calling for the State to increase transparency about MLTC - where does the money go, what services are provided and how much, track record of plans in keeping members out of nursing homes, etc.
21 May, 2024 880 kb Downloads: 38
NYLAG Statement Opposing Proposed Cuts to the CDPAP Program in NYS 2024-25 Budget Download
NYLAG MEMORANDUM IN OPPOSITION - CDPAP in 30-day Amendments FINAL.3 (2-27-24).pdf
NYLAG's statement opposing various cuts to the Consumer-Directed Personal Assistance Program proposed by the Governor in the 2024-25 Budget. (revised 2/27/24)
27 Feb, 2024 696 kb Downloads: 885
NYLAG Memo in Support of HOME CARE SAVINGS AND REINVESTMENT ACT (S7800/A8470) Download
NYLAG MEMORANDUM IN SUPPORT S7800-A8470.pdf
NYLAG Memo in Support of HOME CARE SAVINGS AND REINVESTMENT ACT (S7800/A8470) that would replace the MLTC program with a managed fee- for service program.
26 Feb, 2024 790 kb Downloads: 411
2024 Medicare Special Needs Plans (SNPs) in NYS Download
NYS 2024 Medicare Advantage Special Needs Plans with plan ratings REVISED.xlsx
2024 Medicare Special Needs Plans (SNPs) in NYS, with Star Ratings (as of 10/5/23). Indicates whether plan is aligned with and part of a Medicaid Advantage Plus (MAP) plan (includes MLTC plan in same plan) or an IB-Dual plan (Integrated benefit - Dual) which is a type of a Medicaid managed care plan for people who have Medicare. These plans are subject to Default Enrollment. See http://health.wnylc.com/health/entry/226/ and https://www.health.ny.gov/health_care/medicaid/redesign/duals/index.htm
21 Nov, 2023 227 kb Downloads: 489
NYLAG Comments to CMS Proposed Standards for Improved Access to Home & Community Based Services Download
NYLAG Comments HCBS-Access Rule 6-30-23 CMS-2442-P.pdf
NYLAG filed these comments on June 30, 2023 to the federal CMS Medicaid agency's proposal to improve standards for accessing Home and Community-Based Services (HCBS) Provisions - see CMS summary at https://www.cms.gov/newsroom/fact-sheets/ensuring-access-medicaid-services-cms-2442-p-notice-proposed-rulemaking and

https://www.cms.gov/newsroom/press-releases/biden-harris-administration-proposes-new-standards-help-ensure-access-quality-health-care-medicaid#
18 Sep, 2023 940 kb Downloads: 372
NYC HRA Medicaid Alert NY Independent Assessor & Changes to Personal Care (PCS) Assessment Process (5/31/23) Download
2023-05-31 NYIA and Changes to Personal Care Assessment Process.pdf
Explains what consumers seeking Medicaid CDPAP or personal care (PCS) should do in 2 situations: (1) Those who contacted NYIA directly, rather than applying for Immediate Need services and who are not in a Mainstream Medicaid managed care plan (known as "Fee for service (FFS) consumers") - If the NYIA notice says they are not eligible to enroll in MLTC and refers them to the LDSS - they should fax a copy of their NYIA decision notice to the CASA Central Intake unit (718) 636-7784. Case will be assigned to a CASA to use the notice to retrieve the NYIA assessments and then proceed to assess whether eligible for PCS or CDPAPt. But.. if they are a dual eligible and not in a hospice program, or in OPWDD, TBI or NHTD waiver - they are probably only eligible for 8 hours/WEEK of Housekeeping services from CASA. T

(2) If you applied to HRA for Immediate Need services - PCS or CDPAP via eFax (917) 639-0665 - you should not have to contact the HRA Home Care Services Program/CASA after the NYIA assessessments -- because NYIA should notify CASA of the outcome of the assessments directly and they should contact you about next steps to decide if you are eligible for services and if so - what is your plan of care.
03 Jun, 2023 132 kb Downloads: 1028
MAPDR-05 (08/04/2022) List of Managed Care & Managed Long Term Care Plans in NYC Download
2022-08-04 MAPDR-05 Medicaid Managed Care Plans NYC.pdf
This includes a list of all managed care organizations participating in the following types of Medicaid managed care, including ID and code numbers, contact information, and service areas:
* Medicaid Managed Care
* Health and Recovery Plan Managed Care Plans (HARP)
* Managed Long Term Care (MLTC)
* Medicaid Advantage Plus (for dual eligibles, includes MLTC)
* HIV Special Needs Plans (SNP)
* Programs of All-inclusive Care for the Elderly (PACE)
* Fully Integrated Dual Advantage (FIDA) IDD

Updated August 4, 2022 (current on HRA site as of 5/31/23)
31 May, 2023 129 kb Downloads: 61014
MAP-648 P SUBMISSION OF REQUEST FROM RESIDENTIAL HEALTH CARE FACILITIES (RHCF)(05/05/2022) Download
MAP-648p Submission of request from RHCF-NH 2022-05-05.pdf
Transmittal form for Nursing Home to submit to HRA: new Medicaid application, request to convert coverage from community Medicaid, upgrade coverage, or notify HRA that transfer penalty period expired. (updated 5/5/2022)
25 Mar, 2023 69 kb Downloads: 10372
List of 2023 Medicare Special Needs Plans (SNPs) in NYS Download
2023 New York State Special Needs Plans updated 3-6-23.xlsx
List of 2023 Medicare Special Needs Plans (SNPs) in NYS. Indicates whether plan is aligned with and part of a Medicaid Advantage Plus (MAP) plan (includes MLTC plan in same plan) or an IB-Dual plan (Integrated benefit - Dual) which is a type of a Medicaid managed care plan for people who have Medicare. These plans are subject to Default Enrollment. See http://health.wnylc.com/health/entry/226/. List updated in March 2023 with new plans and counties using Default Enrollment.
06 Mar, 2023 74 kb Downloads: 1047
NYLAG PowerPoint on NY Independent Assessor - Feb. 2023 Download
NYIA Webinar CLE Slides Handout 2-2023.pdf
Presentation given in webinar conducted by NYLAG Evelyn Frank Legal Resources Program on Feb. 8, 2023 on the NY Independent Assessor.
15 Feb, 2023 1.99 mb Downloads: 1653
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