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Medicaid Managed Care
Letters Asking Governor & State DOH to Halt Disenrollment from MLTC Plans for Nursing Home members until Pandemic Over Download
2020-07-02 Consumer LT GOV NH Disenrollment FINAL.pdf
Letter of 7/2/20 to Gov. Cuomo and letter dated June 29, 2020 to DOH from NYLAG, Legal Aid Society, CIDNY, Empire Justice Center & other organizations demanding the state halt disenrollment of almost 20,000 MLTC members from their MLTC plans because they have been in nursing homes for more than 3 months. With visitors banned from nursing homes, they'll have no help to appeal - and many will be forced to stay in the nursing homes, at risk of exposure to COVID.
12 Jul, 2020 1.37 mb Downloads: 2254
NYSDOH Dear Administrator Letter to Nursing Homes 6-11-2020 re Disenrollment from MLTC of Nursing Home Residents Download
DAL Updated NHBL 6.11.20.pdf
NYSDOH Dear Administrator Letter (DAL) to Nursing Homes 6/11/2020 revising the one issued 1-21-2020 (posted at http://www.wnylc.com/health/download/718). DAL advising them that residents who are members of MLTC plans will be disenrolled after 3 months in NY. The letter should eventually be posted with other DAL letters here - https://www.health.ny.gov/professionals/nursing_home_administrator/letters.htm#dal. See discussion in this article http://www.wnylc.com/health/entry/199/
28 Jun, 2020 181 kb Downloads: 2368
NYLAG, Empire Justice Center & Bronx Legal Serv Letter to DOH re MLTC/ Home Care Protections re Covid-19 0 4/1/2020 Download
LT DOH NYLAG-EJC-BxLS 4-1-2020 FINAL.pdf
Letter from Advocates to NYS Dept. of Health requesting clarification of various policies issued re Covid-19 and for protections for Medicaid home care applicants and recipients in MLTC, mainstream managed care plans and other home care programs.
03 Apr, 2020 432 kb Downloads: 2650
NYLAG, Legal AId, EJC & Other Advocates Letter to OTDA 3-24-20 on Covid-19 Fair Hearing Procedures Download
COVID19 OTDA FH LTR FINAL 3-24-20.pdf
Letter from advocates to the NYS Office of Temporary & Disability Assistance, 3/24/20 requesting clarification of GIS isued 3/12/2020 https://otda.ny.gov/policy/gis/2020/20DC014.pdf establishing phone hearing procedures during Covid-19 and as a demonstration program.. Letter requests additional protections for appellants.
01 Apr, 2020 122 kb Downloads: 2023
NYLAG Statement Opposing Proposed Medicaid Redesign Team II Cuts in Home Care, Eligibility & Prescription Drugs Download
NYLAG - MRT Statement - 3-18-20.pdf
For the NYS Budget 2020-21, Gov. Cuomo appointed the Medicaid Redesign Team II to recommend Medicaid cuts to balance the budget. A set of proposals were developed by the MRT and are supposed to be voted on by the MRT on 3/18 or 3/19. Between then and April 1, 2020 the legislature and Governor are supposed to agree on a budget. NYLAG opposes many of the recommended cuts in Medicaid eligibility and access to home care and prescription drugs.
18 Mar, 2020 310 kb Downloads: 2767
NYS Notice of Disenrollment to MLTC Members in Nursing Homes for 3+ Months (revised 2-27-20) Download
DU Batch Notice 2.27.20 Draft Final.docx
Revised form Notice to be sent by New York Medicaid Choice to about 23,000 MLTC members who, as of April 2020 have been in nursing homes for 3+ months, telling them they will be disenrolled from the MLTC plan unless they request an assessment to return home or a fair hearing before the effective date, May 1, 2020.
09 Mar, 2020 48 kb Downloads: 3178
NYS DOH-OTDA WMS Workers' Guide to Codes (2-9-2017)(Excerpt on MEDICAID only) Download
Workers Guide to Codes - MEDICAID ONLY 2-2017.pdf
Excerpt of State publication that explains the millions of eligibility codes that show restrictions on or categories of individual's Medicaid eligibility. The entire guide is much bigger. This SEARCHABLE excerpt contains the chapter on MEDICAID CODES.
25 Feb, 2020 3 mb Downloads: 4802
Know Your Rights: Former Members of ICS MLTC Plan - Update on Your Rights - Feb. 2020 Download
MLTC Plan Closings - February 2020 Update for Former ICS Members - NYLAG.pdf
Most members of ICS MLTC plan transferred to VNS Choice MLTC plan after ICS closed April 1, 2019. This fact sheet explains your rights if your new plan tries to reduce your services.
17 Feb, 2020 894 kb Downloads: 2500
Consumer Groups Demand Changes in Notices Disenrolling Members from MLTC Plans because in Nursing Homes 3+ Months Download
Consumer LT DOH NH Disenrollment 2-10-2020.pdf
Letter send Feb. 10, 2020 to State DOH requesting changes in notices and other procedures for disenrolling MLTC members from their MLTC plans because they are "long term" nursing home residents, defined as in a nursing home 3+months. See more info at http://www.wnylc.com/health/entry/199/
10 Feb, 2020 322 kb Downloads: 2718
NYSDOH Dear Administrator Letter to Nursing Homes 1-21-2020 re Disenrollment from MLTC of Nursing Home Residents Download
NHBL DAL Final 2020-01-21.pdf
NYSDOH Dear Administrator Letter to Nursing Homes 1-21-2020 advising them that residents who are members of MLTC plans will be disenrolled after 3 months. The letter should eventually be posted with other DAL letters here - https://www.health.ny.gov/professionals/nursing_home_administrator/letters.htm#dal. See discussion in this article http://www.wnylc.com/health/entry/199/
22 Jan, 2020 193 kb Downloads: 2621
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