NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC
Medicaid Managed Care
NYLAG comments about Independent Assessor Procedures - 2-02-2022 Download
2022-02-02 NYLAG questions about NYIA slides 12-21-22 + 1-14-22 (Topic 1).pdf
NYLAG comments and questions to State DOH dated 2-2-2022, about the first sets of PowerPoints posted on new NY INdependent Asssessor website - https://www.health.ny.gov/health_care/medicaid/redesign/nyia/faqs/index.htm. These comments are about the 12-2021 presentations and Topic 1 presentations dated Jan. 14, 2022
19 Mar, 2022 93 kb Downloads: 1425
Contact List - Medicaid Managed Care Organizations in NYC Download
2021-12-30 MADPR-05 Medicaid Managed Care Plan.pdf
Contact List - Medicaid Managed Care Organizations in NYC (updated 12-30-2021)
09 Feb, 2022 150 kb Downloads: 2246
Webinar on NYS Medicaid Home Care Changes in 2022 - by NYLAG Evelyn Frank Program - Jan. 26, 2021 Download
Medicaid Home Care CLE Webinar Jan. 26-2022.pdf
PowerPoint describes the changes in Medicaid Home Care that started being rolled out Nov. 8, 2021. This PowerPoint developed before DOH launched website about Independent Assessor that starts March 1, 2022, so does not include that info posted at https://www.health.ny.gov/health_care/medicaid/redesign/nyia/. Check for more updates at http://www.wnylc.com/health/news/85/. Webinar recording will also be posted. Proposed expansion of financial eligibility for age 65+, disabled, and blind is also discussed.
31 Jan, 2022 2.23 mb Downloads: 1805
Consumer Concerns about Independent Assessor Implementtion - 12/15/22 letter updates Jan. 6, 2022 Download
Consumer Concerns re Implementing Independent Assessor 12-15-22 with 1-6-22 Followup.pdf
12/15/22 letter sent to DOH jointly from Medicaid Matters NY and NYLAG with concerns about implementation of the Independent Assessor changes on March 1, 2022 - with no guidance or procedures yet issued let alone tested and ready, and with a lack of capacity for NY Medicaid Choice to handle the huge demand of approximately 300,000 nurse assessments and 300,000 physician/practitioner assessments a year.
11 Jan, 2022 2.45 mb Downloads: 1972
NYLAG PowerPoint on 2021-22 Medicaid Home Care Changes & Lookback Download
NYLAG Budget PowerPoint Home care changes 10-2021.pdf
Powerpoint with latest info - as of Oct. 20, 2021 -- on implementation of changes enacted in the NYS FY 2020-2021 budget, including the restrictions on eligibility for Personal Care services (PCS) and CDPAP services (reqiring 2-3 ADLs), the Independent Assessor procedures, and the loosened standards allowing plans to more easily reduce hours of home care after a "transition period" for certain members.
20 Oct, 2021 1.31 mb Downloads: 1903
DOH Model 30-Day Notice of Intent to Disenroll from MLTC Plan for Long Term Nursing Home Stay Download
Plan Intent to disenroll Batch Process_07.01.21_Final.pdf
Notice sent by MLTC plans to members of intent to disenroll because of a Long Term Nursing Home Stay - a stay of more than 3 months, where the member has been approved for Nursing Home Medicaid. Notice sent 30 days prior to disenrolllment. A second notice is sent by NY Medicaid Choice 10 days prior to disenrollment, posted with more info in this article http://www.wnylc.com/health/entry/199/
20 Oct, 2021 83 kb Downloads: 1746
List of 2022 Medicare Special Needs Plans (SNP's) in NYS Download
2022 NYS Special Needs Plan Landscape with Insulin.xlsx
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).
11 Oct, 2021 87 kb Downloads: 1740
Know Your Rights: Varshavsky - Special Rights in Home Care Hearings if Consumer is Homebound Download
Varshavsky Fact Sheet (2021-09-24) with attachments.pdf
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)
24 Sep, 2021 1.1 mb Downloads: 4589
Advocacy 8-5-21 Letter to CMS with Concerns re NYS Spending Plan for Federal HCBS Funding Download
NYS HCBS eFMAP plan consumer advocate CMS ltr 8.5.21 final.pdf
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/.
13 Sep, 2021 427 kb Downloads: 1390
Know your Rights: Tips for Requesting New or Increased Services from a Medicaid Managed Care or MLTC Plan Download
Requesting Services from an MCO 2021.pdf
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/.
03 Aug, 2021 360 kb Downloads: 4448
Prev Next
1 2 3 4 5 6 7 8 9 10


This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.