State policy implementing expansion of mandatory enrollment of people needing permanent nursing home coverage into managed care and Managed Long Term Care (MLTC) plans. Mandate is to start April 1, 2014, subject to CMS approval not yet given as of March 13, 2014.

Published in March 2014

After the Federal CMS agency entered a "memorandum of understanding" with NYS to approve the FIDA proposal to manage care for Dual Eligibles, a 3-way contract had to be approved between the State, the Feds and the FIDA plans. THis is the consumer coalition's comments on what protections are needed in this contract.

letter being sent starting July 2012 to all NYC Medicaid personal care recipients, unless exempt from mandatory MLTC enrollment. Sent in rolling schedule - see article

Paper dated March 23, 2012 filed with US Center for Medicare & Medicaid Services and NYS Dept. of Health to incentivize community-based services in the roll-out to mandatory managed long term are.

Alert 9/19/2012 The purpose of this Alert is to inform Community Based Organizations, Client
Representatives, Certified Home Health Agencies and other providers that the waiver
“look-alikes” exemption for managed care ended September 1st.

This exemption had been available for consumers who have the same characteristics and needs as
consumers enrolled in Medicaid waiver programs such as Traumatic Brain Injury,
Care at Home, Home and Community Based Services for the Developmentally
Disabled, and the Nursing Home Transition Waiver, but are not enrolled in a waiver
program.

Such consumers may decide they now want to apply for a waiver program or
designation as developmentally disabled. Because this process may take more than
30 days, SDOH has decided to allow an exemption for up to six months for non -
dually eligible consumers who are in the process of applying for a waiver program or
designation as developmentally disabled. To qualify for this exemption, consumers
must call NY Medicaid Choice at 800-505-5678, to inform staff that they are applying
for waiver services.

This list was released by DOH to the Long Term Care Community Coalition in April 2013, in response to a Freedom of Information request

8-13-13 MICSA Alert detailing the housekeeping conversion process to facilitate consumer disenrollment from MLTC plans to HRA.

NYLAG training materials, including PowerPoint and Appendix, on Medicaid Managed Long-Term Care in New York. As of 6/21/2013, the latest version of the presentation given by the Evelyn Frank Legal Resources Program 50 times in the last year.