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.

Fact Sheet about the Class Action Injunction in the Varshavsky v Perales case, which gives special rights for people appealing adverse denials of increases of Medicaid home care services. In some cases, the consumer has the right to a temporary increase in home care hours 45 days after requesting the hearing, while the hearing takes its course. If a phone hearing cannot be favorably decided, the consumer has the right to a home hearing. Learn advocacy tips in this fact sheet, also posted as an article at http://www.wnylc.com/health/entry/228/ (with updated OTDA contact info 9-24-21)

Official template for NYS Medicaid Advantage Plus plans to deny an initial request for prior approval for a service or for an increase in a service. See article at http://www.wnylc.com/health/entry/225/. This form is from a zipped file of MAP notice templates posted at https://www.cms.gov/files/zip/nyiagintegratedbenenotices.zip.

State template for final decisions after the internal plan appeal in the new integrated appeal procedure that began in 2020 for MAP plans. See article at http://www.wnylc.com/health/entry/225/. This form is from a zipped file of MAP notice templates posted at https://www.cms.gov/files/zip/nyiagintegratedbenenotices.zip.