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Medicaid Managed Care
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: 2751
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: 2943
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: 2897
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: 2926
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: 3017
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: 2831
LDSS-3559 Form (2013 version) Nursing Home Report to DSS of Medicaid Recipient Admission/Discharge Download
LDSS-3559 RHCF Report of Medicaid Recip Admission-Change in Status (2013).pdf
LDSS-3559 Form RESIDENTIAL HEALTH CARE FACILITY REPORT OF MEDICAID RECIPIENT ADMISSION/DISCHARGE/READMISSION/CHANGE IN STATUS. This is last version of form from 2013, which DOH has said is under revision
22 Jan, 2020 93 kb Downloads: 17435
MAPDR-21 - Medicaid Managed Care Exemptions and Exclusions Download
MAPDR-21 Medicaid Managed Care Exemptions and Exclusions 9-28-2015.pdf
This documents lists which categories of beneficiaries are exempt or excluded from the requirement of joining a mainstream medicaid managed care plan. Rev'd 9/28/15
03 Jan, 2020 71 kb Downloads: 16225
State Model " Non-Passive Enrollment" Notice #2 Sent to Members of Only TWO FIDA Plans that FIDA Closing Download
Final FIDA Non-Renewal Model Letter - Non-Passive Enrollment - 09.25.19 ORIGINAL.PDF
Final FIDA Non-Renewal Model Letter - "Non-Passive Enrollment" - "Notice 2" 09.25.19
State Template for notice sent to members of only TWO FIDA plans -- Riverspring and those in Senior Whole Health FIDA who live OUTSIDE the Bronx. The notice says the FIDA program is closing Dec. 31, 2019. This notice tells members of these plans that unless they select a different plan before Dec. 20, 2019, they will be assigned to a Managed Long Term Care plan operated by the same company that operates their FIDA plan. If they do nothing, these members will be assigned not only to an MLTC plan but also randomly assigned to a Medicare Part D drug plan, and enrolled in Original Medicare January 1, 2020.

Members of the other 4 FIDA plans and those in Senior Whole Health who live in the Bronx received "Notice 1" - Passive Enrollment notice, posted at http:// www.wnylc.com/health/download/703/
07 Oct, 2019 340 kb Downloads: 2387
State Model "Passive Enrollment" Notice (1) Sent to Members of Most FIDA Plans that FIDA Closing Download
Final FIDA Non-Renewal Model Letter - Passive Enrollment - 09.25.19 ORIGINAL.PDF
State Template for "Notice 1" or "Passive Enrollment" notice sent to members of most FIDA plans that FIDA program is closing Dec. 31, 2019. This notice tells members in this group that unless they select a different plan before Dec. 20, 2019, they will be assigned to the Medicaid Advantage Plus(MAP) plan operated by the same company that operates their FIDA plan. This "Notice 1" sent to members of all FIDA plans EXCEPT Riverspring, and for those in Senior Whole Health FIDA, only members who live in the Bronx received this notice.
07 Oct, 2019 309 kb Downloads: 2048
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