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Medicaid Managed Care
NYC HRA MICSA/NHED Submission Protocol - Transition of Nursing Home Benefits into Medicaid Managed Care Download
MICSA-NHED Submission Protocol Transition of NH into MMC-MLTC 10-26-15.pdf
Official training PowerPoint for MLTC and Managed care plans, nursing homes and NYC Medicaid staff on submission of Medicaid applications for nursing home care under new 2015 changes requiring permanent nursing home residents to enroll in or stay in managed care or mLTC plans. October 2015.
22 Nov, 2015 794 kb Downloads: 21627
NYS Duals Coalition Statement on Issues in Nursing Home Transition to MLTC and Managed Care (Oct. 2015) Download
Issues in Carve-in Nursing Home Benefit CPRNYDE 10-22-15.pdf
Coalition to Protect the Rights of NY Dually Eligible - Issues and Concerns Related to the Carve-in of Nursing Home Benefit into Mainstream Managed Care and MLTC
22 Nov, 2015 353 kb Downloads: 5250
Table of MLTC & FIDA Enrollment in NYS - OCt. 2015 Download
Enrollment in FIDA and MLTC Plans – October 2015.2.pdf
Excerpt of data from Excel chart posted at http://www.wnylc.com/health/download/588/ For more breakdown re enrollment in MLTC plans in upstate counties see most recent report in https://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/ - tab for MLTC plans.
08 Nov, 2015 102 kb Downloads: 3150
Spreadsheet with Oct. 2015 Enrollment Data for FIDA and MLTC in NYS Download
Monthly_Report_By_FIDAPlan_2015_10.2.xls
Data from CMS Medicare Advantage monthly data and NYS DOH monthly managed care enrollment data https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-Enrollment-by-Plan.html and https://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/

Both for October 2015.
08 Nov, 2015 46 kb Downloads: 2913
2nd Notice of Passive Enrollment into HARP/Behavioral Health Organization - 8/2015 Download
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.
06 Nov, 2015 237 kb Downloads: 3648
NYS Announcement Letter Passive Enrollment into HARP Sister Plan Download
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.
06 Nov, 2015 277 kb Downloads: 3855
Caregiver FIDA Fact Sheet (Korean) Download
Caregiver Fact Sheet (Korean) FINAL.pdf
19 Sep, 2015 596 kb Downloads: 5988
MICSA - Renewal Status File Download
HRA Presentation to MLTC Plans - Renewal Status File.pdf
Presentation from NYC Human Resources Administration to managed care plans on the NYC process for helping managed care plans work with their members to renew Medicaid coverage. Describes renewal timeline in general, as well as special weekly data file (RS) sent to plans to help them identify members who need follow-up. May 14, 2012.
27 Jul, 2015 171 kb Downloads: 3294
State DOH Templates for MLTC Denials, Reductions, Terminations - effective July 1, 2015 Download
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
25 Jun, 2015 1.2 mb Downloads: 44517
Number Enrolled in Each FIDA and MLTC plan in FIDA Demo Area - April - May 2015 Download
MLTC and FIDA Enrollment April May 2015 FIDA plans only.xlsx
Data compiled from CMS site https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-Enrollment-by-Plan-Items/Monthly-Enrollment-by-Plan-2015-05.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending

and DOH site http://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/
01 Jun, 2015 16 kb Downloads: 4758
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