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Medicaid Managed Care
NYLAG, Legal AId, EJC & Other Advocates Letter to OTDA 3-24-20 on Covid-19 Fair Hearing Procedures Download
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: 1778
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: 2519
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: 2860
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: 4488
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: 2239
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: 2456
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: 2371
Disenrollment Notice Sent to MLTC Members who are Long Term Nursing Home Residents Download
DU_MLTC_NH_E_1019 Disenrollment notice - NH.pdf
New Disenrollment Notice form to be sent by NY Medicaid Choice to MLTC Members who have been identified as "Long Term Nursing Home Residents" (In nursing home more than 3 months). Notice has Fair Hearing rights. See more here http://www.wnylc.com/health/entry/199/
22 Jan, 2020 600 kb Downloads: 2268
DOH Notice to all MLTC Members Announcing Change That Takes Nursing Home Care Out of MLTC Download
SM-MLTC-NHBC-E-0120 General Info notice.pdf
Notice sent to all MLTC members by State DOH in week of Jan. 17, 2020 explaining the change in how nursing home care relates to MLTC. If in a nursing home for more than 3 months, will no longer be eligible for or remain in an MLTC plan. See http://www.wnylc.com/health/entry/199/.
22 Jan, 2020 276 kb Downloads: 2513
Notice sent Jan. 2020 to Nursing Home Residents Approved for Medicaid that won't be enrolled in MLTC plans Download
NYMC Notices to NH Residents will not be enrolled in MLTC plans (2 notices).pdf
This PDF has 2 form notices being sent in Jan. 2020 to adult Nursing Home Residents approved for Institutional Medicaid, advising them that they won't be enrolled in MLTC plans as previously notified. This is implementing the change approved by CMS for MLTC. See http://www.wnylc.com/health/entry/199/. The 1st notice is to those who received notice that they must select an MLTC plan by a certain date. The 2nd notice in the PDF is to those who were told they'd be assigned to an MLTC plan on February 1, 2020. That enrollment is now canceled.
22 Jan, 2020 1.46 mb Downloads: 2319
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