Fact Sheet by NYLAG Evelyn Frank Legal Resources Program explaining the "transition rights" of MLTC members when their MLTC plan closes.

If you received Immediate Need home care, or your MLTC plan closed, or you were disenrolled from your MLTC plan involuntarily, you are required to enroll in or switch MLTC plans. You have "continuity" or "transition" rights in your new MLTC plan. Learn about those rights and current changes in the rules for what happens when the "Transition Period" ends after 90-120 days.

The New York Independent Assessor (NYIA) has posted an "Information Sharing Consent Form" for you to authorize release of health information to NYIA. The consent form allows NYIA to contact your doctors and other medical providers as needed for them to assess your eligibility to enroll in a Managed Long Term Care (MLTC) plan, or for you to obtain Medicaid personal care or Consumer-Directed Personal Assistance (CDPAP) services from your local Medicaid office or Medicaid health plan. You can also designate an authorized representative who may act on your behalf when interacting with NYIA.

To find the form, go to https://nyia.com/en/consent. This guide explains how to complete, e-sign and submit the form online, which is not easy. It also explains how to print a blank form. A PDF copy is also attached to this Guide.

NYS solicited public comments on its draft proposal that it will submit to CMS requesting an 1115 waiver for "Strategic Health Equity Reform Payment Making Targeted, Evidence-Based Investments to Address the Health Disparities Exacerbated by the COVID-19 Pandemic." Proposal is posted at
www.health.ny.gov/health_care/medicaid/redesign/2022/docs/2022-04_1115_waiver_draft_amendment.pdf
NYLAG's comments are attached.

In late April, DOH released an ADM and an MLTC policy with procedures for the Independent Assessor (posted at https://www.health.ny.gov/health_care/medicaid/redesign/nyia/repository/index.htm). On May 3, 2022 NYLAG sent these comments and requests for clarification to DOH.

NYLAG's second set of comments and questions about the Independent Assessor slides posted by DOH on https://www.health.ny.gov/health_care/medicaid/redesign/nyia/. This set is about PowerPoints for Topics 2 and 3. NYLAG's 1st set of comments were about Topic 1 and the High Level OVerview from Dec. 2021, and is posted at http://www.wnylc.com/health/download/807/. For more info see http://www.wnylc.com/health/news/85/#Independnet%20Assessor%20NEW.

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

A Medicaid Recipient who submits medical bills from a Provider to meet the spenddown will receive an OHIP-3183 “Provider/Recipient Letter” indicating which medical expenses are the responsibility of the Recipient (and which the Provider should not bill to Medicaid). When the Recipient is enrolled with a Managed Long Term Care Plan (MLTC), the Recipient and the MLTC will receive an OHIP-0128 “MLTC/Recipient Letter” indicating the amount that the Recipient owes to the MLTC (after deducting the medical expenses/bills from the spenddown). These forms replace the LDSS-3183 form.

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.

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.