Exhaustion of MLTC Plan Appeals Before Requesting a Fair Hearing, Starting May 1, 2018,)(By Valerie Bogart; reprinted with permission from: Elder and Special Needs Law Journal, Spring 2018, Vol, 28 No. 2, published by the New York State Bar Association, One Elk Street, Albany, NY 12207.

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.

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.

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/

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.

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."

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

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)

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/