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Guildnet FIDA Closing Letter Download
Guildnet FIDA Closing Notices - Combined.pdf
31 Oct, 2018 721 kb Downloads: 2454
Guildnet Closing Notice sent by NY Medicaid Choice dated Oct. 19, 2018 to 8000+ members Download
Guildnet closing Notice 10-2018.pdf
Notice sent by New York Medicaid Choice, the enrollment contractor for NYS Dept. of Health handling MLTC enrollment. Notice sent to nearly 8000 members of Guildnet's MLTC and Medicaid Advantage Plus plans that Guildnet closing 12/31/19. If they don't select a new plan by 12/19 they will be autoassigned for January 1st. Explains 120 days of continuity of care in new plan.
29 Oct, 2018 1.93 mb Downloads: 2685
Announcement of CLE/Training on Managed Long Term Care - Nov. 14, 2018 1 PM - 5:30 PM Download
NYALCA - Medicaid Seminar Registration Form November 2018.pdf
The New York Aging Life Care Association is pleased to announce a seminar:
NYS MEDICAID AND MLTC 2018 Medicaid & MLTC Changes enacted in NYS 2018-19 Budget.

Registration info in announcement.
21 Sep, 2018 765 kb Downloads: 2967
HRA Medicaid Alert 7/26/18 Special Income Standard for Housing Expenses when Discharged from Nursing Home to MLTC Download
2018-07-26 Medicaid Alert - Special Income Standard for Discharge from NH to MLTC.pdf
Update about the Special Income Standard for Housing Expenses for Individuals
Discharged from a Nursing Facility and who Enroll into the Managed Long Term Care Program - see article at http://www.wnylc.com/health/entry/212/
28 Aug, 2018 303 kb Downloads: 3978
Letter 8/21/18 from Guildnet CEO to Guildnet Employees announcing Guildnet will be closing 12/1/18 Download
Guildnet closing LT employees 2018-08-21.pdf
Letter from Alan Morse, CEO of Guildnet, dated 8/21/18 to Guildnet employees stating that Board decided the previous day to close Guildnet effective 12/1/18. States that the plan will be working closely with the State Dept. of Health on the transition of its members to other MLTC plans. Does not state that the Dept. of Health has approved the closure.
27 Aug, 2018 2.04 mb Downloads: 3499
ICS Letter to Member Council, June 22, 2018 regarding possible plan closure Download
ICS LET-6-22.jpg
Memo dated June 22, 2018 to Member Council of Independence Care Systems stating that closure of ICS MLTC plan would likely be announced in early fall, 2018, and that members would receive 90 days notice to choose another plan, or they would be assigned to VNS Choice. The memo states, "Members will be guaranteed the same level of care (continuity of care) for at least 120 days or until a new assessment is done." The memo states, "It is in each ICS member's best interest to stay at ICS until notification comes from DOH because the extended continuity of care will only be offered to people at ICS at the time of notification."
09 Jul, 2018 377 kb Downloads: 2998
Fact Sheet on New Rules for Appealing Actions by Medicaid Managed Care and MLTC Plans - Starting May 1, 2018 Download
Exhaustion Fact Sheet - NYLAG 4-25-18.pdf
Fact Sheet on New Rules for Appealing Actions by Medicaid Managed Care and MLTC Plans - Starting May 1, 2018 - by NYLAG Evelyn Frank Legal Resources Program
25 Apr, 2018 295 kb Downloads: 6091
NYLAG Webinar on Exhaustion and MLTC Appeals - PowerPoint April 18, 2018 (amended 4/22/18) Download
NYLAG Exhaustion Webinar PowerPt FINAL amended.pdf
Compilation of regulations, sample notices, forms, advocacy documents, fact sheets, and online references for CLE Webinar conducted by NYLAG EFLRP on April 18, 2018 on the new Appeals REquirements for Medicaid Managed Care as Implemented in NYS Effective May 1, 2018 (amended slides 5 and 7 4/22/18)
22 Apr, 2018 610 kb Downloads: 6834
Form to Designate Representative to Request Managed Care/MLTC Appeal or Hearing (Rev. 4-16-18) Download
AUTHORIZATION – Medicaid Managed Care Requests (2018-04-16).pdf
Form designed by NYLAG EFLRP for a managed care or MLTC member to designate a family member, attorney or care manager, provider, and/or the ICAN Ombudsprogram to request a plan appeal, fair hearing, or a change in services from a managed care or MLTC plan. This new form is necessary because of changes starting in March 2018. At that time, one must first request an internal plan appeal before requesting a fair hearing. The request must be signed by the plan member unless a representative was previously designated. Signing this form in advance could prevent harmful delays in obtaining a client signature when requesting an appeal- especially if Aid Continuing is needed. See more at http://www.wnylc.com/health/news/80/
16 Apr, 2018 261 kb Downloads: 4731
NYS Dept. of Health Webinar Powerpoint about New Appeals Rules in Managed Care and MLTC that Start May 1, 2018 Download
Public Informational Webinar 42 CFR 438 Service Auth and Appeals March 2018.pdf
Powerpoint from a public webinar DOH held on Mar. 28 and 30, 2018. DOH has stated that the webinar and slides will be posted for viewing, but as of April 11, 2018 they are not yet posted. As a public service NYLAG is posting the slides from the presentation.
11 Apr, 2018 311 kb Downloads: 4156
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