List of 2022 Medicare Special Needs Plans (SNP's)in NYS. Indicates whether plan is also a Medicaid Advantage Plus (MAP) plan (includes MLTC plan in same plan), and whether the plan is subject to Default Enrollment. See more about that at http://www.wnylc.com/health/entry/226/. Notes which plans participate in Senior Savings Program for which copay for insulin is never more than $35/mo. (That insulin program is irrelevant to those with Extra Help).

Fact Sheet about the Class Action Injunction in the Varshavsky v Perales case, which gives special rights for people appealing adverse denials of increases of Medicaid home care services. In some cases, the consumer has the right to a temporary increase in home care hours 45 days after requesting the hearing, while the hearing takes its course. If a phone hearing cannot be favorably decided, the consumer has the right to a home hearing. Learn advocacy tips in this fact sheet, also posted as an article at http://www.wnylc.com/health/entry/228/ (with updated OTDA contact info 9-24-21)

Letter sent by NYLAG, Medicaid Matters NY, Legal Aid Society, Empire Justice Center and other NYS advocacy organizations to CMS dated Aug. 5, 2021. Expresses concerns about the NYS plan for spending billions of enhanced federal Medicaid dollars available under the American Rescue Plan Act of 2021 (ARPA) that must be used for enhancing access to Home & Community Based Services (HCBS). NYS Spending Plan and other info about this funding is at https://www.health.ny.gov/health_care/medicaid/redesign/hcbs/enhanced_funding/.

Fact Sheet prepared by the NYLAG Evelyn Frank Legal Resources Program explaining tips on how to request new or increased services from a Medicaid managed care or MLTC plan, including the timeline in which the plan must process the increase. Russian translation posted at http://www.wnylc.com/health/download/782/

If the request is denied, see separate Fact sheet on appealing denials. http://www.wnylc.com/health/download/654/.

Russian Translation of Fact Sheet prepared by the NYLAG Evelyn Frank Legal Resources Program explaining tips on how to request new or increased services from a Medicaid managed care or MLTC plan, including the timeline in which the plan must process the increase. English version is at http://www.wnylc.com/health/download/723/

If the request is denied, see separate Fact sheet on appealing denials. http://www.wnylc.com/health/download/654/

Official template for NYS Medicaid Advantage Plus plans to deny an initial request for prior approval for a service or for an increase in a service. See article at http://www.wnylc.com/health/entry/225/. This form is from a zipped file of MAP notice templates posted at https://www.cms.gov/files/zip/nyiagintegratedbenenotices.zip.

State template for final decisions after the internal plan appeal in the new integrated appeal procedure that began in 2020 for MAP plans. See article at http://www.wnylc.com/health/entry/225/. This form is from a zipped file of MAP notice templates posted at https://www.cms.gov/files/zip/nyiagintegratedbenenotices.zip.

Redacted sample of a letter sent in late March 2021 to 789 members of the Healthfirst Medicaid Advantage Plus plan explaining the plan's mistake in failing to forward their case for a hearing, as required in the new Integrated Appeal process for MAP plans that began 2020. Read about this new appeal process and more about this letter at http://www.wnylc.com/health/entry/225/

Letter to Governor Cuomo and leaders of the legislature calling for NYS Budget initiatives that will ensure access to home care to prevent unnecessary institutionalization -- COVID-19 has been a wake-up call for the need to avoid nursing home placement when ever possible.

NYLAG's comments submitted on the 2nd round of proposed State regulations implementing 2020 changes in State law restricting eligibility for personal care, CDPAP and MLTC enrollment, and changing the procedures for how Medicaid home care services are assessed. The proposed State reg can be found at https://health.ny.gov/health_care/medicaid/redesign/mrt2/express_terms_summary.htm. The NYSBA Elder Law & Special Needs Section comments are also attached to and referenced in the NYLAG comments.