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Medicaid Managed Care
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: 4473
Caregiver FIDA Fact Sheet (Korean) Download
Caregiver Fact Sheet (Korean) FINAL.pdf
19 Sep, 2015 596 kb Downloads: 6520
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: 3787
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: 45321
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: 5224
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 Download
Appendix Final.pdf
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 - includes helpful lists of plans, forms, and a Troubleshooting guide.
27 Apr, 2015 2.24 mb Downloads: 19258
PowerPoint Presentation by NYLAG Evelyn Frank Program on FIDA and MLTC 4/23/2015 Download
2015 NYLAG CLE MLTC-FIDA updated 4-23-2015.pptx
PowerPoint Presentation by NYLAG Evelyn Frank Program on FIDA and MLTC 4/23/2015.
Updated version of presentation in live CLE conducted APril 20, 2015
27 Apr, 2015 1.89 mb Downloads: 5833
Presentación de Powerpoint Sobre FIDA y MLTC Download
Caregiver Presentation Spanish Final 4-13-15.pdf
Esta presentación fue realizada el 13 de Abril 2015 en una organización local en Brooklyn para los residentes de ese edificio. La presentación es en español. Esta presentación se enfoca en los temas de Medicare, Medicaid, planes de cuidado a largo plazo (MLTC), y planes de doble ventaja totalmente integrado (FIDA).

Debe de usar estos materiales con la grabación sobre FIDA.

This presentation took place on April 13th, 2015 for local Brooklyn residents residing in senior housing. The presentation was conducted in Spanish. The presentation discussed Medicare, Medicaid, Managed Long Term Care plans (MLTC), and Fully Integrated Dual Advantage plans (FIDA).

Please view the powerpoint in conjunction with the Spanish recording of the presentation.
27 Apr, 2015 355 kb Downloads: 4357
Consumer Coalition Proposed Revision - FIDA NOTICES 3-4 - 60-Dayand 30-Day Passive Enrollment Notice (5/30/14) Download
FIDA 60 day and 30 day Notices combined 04-20-2015.pdf
On May 22, 2014, DOH provided Consumer advocates with drafts of notices regarding passive enrollment in FIDA to begin fall 2014. This is the Consumer coalition's proposed revision of NOTICEs 3 and 4 (60-day and final 30-day notices before Passive Enrollment).
20 Apr, 2015 356 kb Downloads: 8560
Troubleshooting Problems Enrolling in MLTC Plans - Tips for Avoiding Delays and Medicaid Spend-down Problems Download
Troubleshooting - 4-16-15 pp.pdf
Fact sheet written by New York Legal Assistance Group Evelyn Frank Legal Resources Problem addressing common problems encountered by those trying to enroll in MLTC plans, especially where they have a spend-down OR are trying to leave a nursing home. Learn how to avoid delays in enrollment. Includes helpful forms, focused on NYC but can be adapted statewide (updated April 15, 2015)
16 Apr, 2015 2.11 mb Downloads: 27567
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