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NYLAG Comments on Medicaid State Plan Amendment to Implement the ADL Restrictions on Eligibility for Personal Care & CDPAP
NYLAG COMMENTS SPA -PCS CDPAP.pdf
Comments filed by NYLAG dated Oct. 29, 2020 on the proposed Medicaid State Plan Amendment (SPA) that would restrict elgibility for personal care and CDPAP services to require 2 or 3 ADL needs. The proposed SPA No. 20-41 was posted September 29, 2020 and is available at https://www.health.ny.gov/regulations/state_plans/status/ltcare/original/docs/os_2020-09-29_spa_20-41.pdf.
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24 Dec, 2020
841 kb
Downloads: 1948
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Sample Notice to MLTC Members Explaining new Lock-In Rule that Starts Dec. 1, 2020
Lock in notice 2020-10 redacted.pdf
Sample Notice sent to MLTC Members in October 2020 Explaining new Lock-In Rule that Starts Dec. 1, 2020. This notice is from VNS Choice, but each plan would be sending their own versiono n their letterhead, using State-approved language.
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29 Oct, 2020
1.95 mb
Downloads: 2737
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MLTC Member Handbook Amendment - New "Lock-in"
MLTC Partial Lock In Member Handbook.pdf
Language that Plans must add to their MLTC Member Handbooks to explain the new Lock-in that begins Dec 1, 2020 for people enrolling in a plan after that date, whether a first-time enrollee or changing plans on or after that date
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29 Oct, 2020
18 kb
Downloads: 2907
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NYLAG Comments on Proposed Changes to State Regulations for Medicaid Managed Care Appeals and Fair Hearings
Final Comments to Proposed Regulations Managed Care Fair Hearing 09.8.2020.pdf
NYLAG Comments filed on Sept. 8, 2020 on Proposed Changes to State Regulations for Medicaid Managed Care Appeals and Fair Hearings. The proposed amendments implement the "exhaustion" requirements implemented in NYS in 2018, implementing federal changes adopted in 2016.
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23 Sep, 2020
511 kb
Downloads: 2498
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NYLAG COMMENTS on Proposed Home Care Changes - Eligibility and Assessment Procedures
NYLAG COMMENTS -PCS CDPAP 2020-09-09 FINAL.pdf
NYLAG COMMENTS on Proposed Regulations implementing the Medicaid Home Care Changes - Eligibility and Assessment Procedures enacted in the 2020-21 NYS Budget. The proposed regulations are posted here - https://regs.health.ny.gov/sites/default/files/proposed-regulations/Personal%20Care%20Services%20and%20Consumer%20Directed%20Personal%20Assistance%20Program.pdf
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09 Sep, 2020
1.07 mb
Downloads: 2660
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NYLAG Comments on Proposed Changes in 1115 Waiver Governing MLTC to Impose "LOOKBACK" for Communiity Based Long Term Care
NYLAG comments 1115 Waiver Lookback 9-9-20 FINAL.pdf
NYLAG Comments on Proposed Changes in 1115 Waiver Governing MLTC to Impose "LOOKBACK" for Communiity Based Long Term Care. The waiver document is posted here https://health.ny.gov/health_care/medicaid/redesign/mrt2/proposals/mltc_elig_vol_enroll_duals.htm
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09 Sep, 2020
652 kb
Downloads: 2770
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PowerPoint on NYS Medicaid Changes Coming in 2020-21 - Lookback, Restricted Home Care Eligibility & New Assessment Procedures
NYLAG Presentation - NYS Budget Changes - Medicaid FY 2020-21.pdf
Webinar presentation by Valerie Bogart, EFLRP, NYLAG, presented on Sept. 9, 2020 on upcoming changes in Medicaid - a new lookback for community based long term care services, new ADL requirements on eligibiliity for personal care and CDPAP, and new assessments for all home care in MLTC, managed care and local Medicaid offices
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09 Sep, 2020
534 kb
Downloads: 4443
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Letters Asking Governor & State DOH to Halt Disenrollment from MLTC Plans for Nursing Home members until Pandemic Over
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.
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12 Jul, 2020
1.37 mb
Downloads: 2811
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NYSDOH Dear Administrator Letter to Nursing Homes 6-11-2020 re Disenrollment from MLTC of Nursing Home Residents
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/
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28 Jun, 2020
181 kb
Downloads: 3009
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Know Your Rights -- If an MLTC Plan Asks You to Reduce Your Hours Because of COVID-19 - You Can Say No
Voluntary Plan of Care change Fact Sheet (FINAL NYLAG 5-18-20).pdf
Fact Sheet for consumers that explains rights of MLTC members in light of a State directive to plans that allows members to "pause" their home care during Covid-19. The directive - at https://health.ny.gov/health_care/medicaid/covid19/docs/2020-04-23_guide_volplanofcare.pdf -- can be helpful for consumers who want to reduce their hours during this emergency, but if you do not want to change your hours, you can keep them as is.
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18 May, 2020
366 kb
Downloads: 3708
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