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 NOTICE 1 - the Announcement notice

DOH provided Consumer advocates with drafts of notices regarding passive enrollment in FIDA to begin fall 2014.

DOH provided Consumer advocates with drafts of notices regarding passive enrollment in FIDA to begin fall 2014.

Presentation to NASW Suffolk Chapter by David Silva at NYLAG

July 12, 2012
The purpose of this ALERT is to inform Community Based Organizations, Client Representatives, Certified Home Health Agencies and other providers that the Medical Assistance Program is changing the way it processes Medicaid applications for excess income eligible consumers seeking enrollment into a Managed Long Term Care (MLTC) plan. Consumers seeking MLTC enrollment who are found to only be eligible for the Medicaid Excess Income (Surplus) Program will now have their cases accepted and authorized with “06” (provisional) coverage. This will occur even if their applications are received without bills that cover their excess or surplus.

This new process will allow MLTCplans to see the provisional coverage on ePaces/eMedNY and will facilitate receipt of services for these consumers. Submitters are requested, when appropriate, to prominently indicate on the cover sheet of submitted applications that the consumer intends to enroll into an MLTC plan

Current policy will remain unchanged for all other consumers found eligible for the Excess Income Program.

All MLTC, MAP, and PACE plans in NYS as of January 2014, organized by company sponsoring the plan. Shows that some companies are sponsoring not just an MLTC plan but also a Medicaid Advantage Plus or Medicaid Advantage plan.

Shows which MLTC plans are sponsoring FIDA plans to be launched in 2014.

Appendix materials provided with NYLAG's webinar on April 24, 2014 providing update on status of Mandatory MLTC initiative in New York State.

PowerPoint presentation used in NYLAG's webinar on 4/24/14 to HIICAP and others.

Coalition to Protect the Rights of NYS Dual Eligibles Comments on State's revised proposal to coordinate Medicare and Medicaid services for dual eligibles, letter dated May 19, 2013. Issues include enrollment of nursing home residents and protections; objections to "passive enrollment" -- auto-assignment of people who don't voluntarily enroll; and incentives for plans to provide long term care services in the community rather than institutions.

This bill would correct two due process violations: (1) The lack of "aid continuing" pending an appeal when a managed care plan reduces or terminates home care or other services -- if the "authorization period" for the services has expired, there is a right to appeal but no right to aid continuing. This provides that aid continuing must be given regardless of whether the authorization period has expired. (2) In Managed long term care, consumers must "exhaust" internal appeals before requesting a hearing. This is not required in mainstream managed care, and results in dismissal of many valid appeals because consumers don't know that they must pursue this interim internal appeal.