News from NYLAG Evelyn Frank Legal Resources Program - Library of Past Newsletters

27 Feb, 2024

The Evelyn Frank Legal Resources Program at NYLAG sends out periodic updates to interested people about developments in Medicaid in New York State affecting seniors and people with disabilities, with an emphasis on people who rely on Medicaid for long-term care services or for subsidies to help with Medicare out-of-pocket costs.

Here are links to past issues of our e-lerts.

2024 -

Feb. 27, 2024 - Home Care is Endangered - CDPAP Cuts Announced for Proposed 2024-25 NYS Budget

Feb. 2024 - Apologies - the links to the past newsletters below are temporarily not working and will be fixed soon

2023

June 20, 2023 Big Changes for New Yorkers on Medicaid This newsletter includes updates on:

A. Unwinding of COVID Public Health Emergency Happening Now - Resumption of Medicaid Renewal Process
B. View EFLRP's Recent Webinars Online
C. More MLTC Plans Closing

June 9, 2023 Update NYLAG Says Farewell to Valerie Bogart as Director of EFLRP and Welcomes Rebecca Wallach as Director

2022

Dec. 21, 2022 - December 2022 Update:

Medicaid financial eligibility increases coming January 2023 - info and register here for a free webinar on January 18, 2023, 10 AM – 12 PM (CLE Pending).
NY Independent Assessor (NYIA) for Home Care Expanded to include Immediate Need Applications Dec. 1, 2022 - info and REGISTER HERE for NYLAG WEBINAR: Update on NYIA
February 8, 2023, 10 AM – 12 PM (CLE pending)
View Recorded Webinar on NYLAG Managed Long-Term Care Data Transparency Project

Oct. 28, 2022 - Announcing Webinars on Medicare Part D Enrollment for 2023 in English & Spanish, and also links to view recently recorded webinars on the upcoming Medicaid changes, Medicaid eligibility, etc.

September 30, 2022 - NYLAG Launches new Managed Long Term Care Data Transparency Project - announcing new webpage at https://nylag.org/MLTCdatatransparency/

May 10, 2022 - May 2022 Update NY Independent Assessor to Start May 16, 2022 - learn about key dates in phasing in this new assessment process for people applying to enroll in MLTC or applying for personal care or CDPAP services with their local DSS or their mainstream Medicaid Managed Care plan; also Justice in Aging Webinar May 11, 2022 about Medicaid Expansion for Aged, Blind & Disabled

Apr. 15, 2022 - April 2022 Update - Medicaid Wins and Losses in NYS Budget -

A. Wins in NYS Budget
B. Losses in NYS Budget
C. Beware: “Independent Assessor” for Home Care Starts May 1, 2022
D. Public Health Emergency Extended Through July 2022

Mar. 30, 2022 - Calling on NYS Governor and Legislature to Pass Budget with Expansion of Medicaid & Medicare Savings Program Eliigibility for People Age 65+ and who have Disabilities - see this article

Jan. 5, 2022 - NYLAG Applauds Governor’s Important Step in Increasing Racial Equity in Health Care with Expansion of Eligibility for Medicaid in New York - Statement by CEO Beth Goldman

2021

Nov. 5, 2021 -

NYS Budget Update: The “Lookback” and Home Care Changes – Start Date Now Pushed into 2022, Except One Major Change Starts Nov. 8, 2021
Medicare Open Enrollment Started Oct. 15th - Dec. 7th - - with Alert for members of Medicaid Advantage Plus (MAP) Plans!
NYLAG and 50 Other Groups Call for Expanded Eligibility for Medicaid & Medicare Savings Program for Aged/Disabled
New 30-Day Notice to MLTC Members Before They are Disenrolled from MLTC Plan Because of Long-Term Nursing Home Stay
Heads Up – Increase Pooled Trust Deposits in 2022 when Social Security Benefits Increase
COVID-19 UPDATES

April 6, 2021 -

Medicaid Advantage Plus (MAP) Fair Haring Mistake Affects 789 Consumers;
New Default Enrollment into Dual-Special Needs Medicare Advantage Plans for new Medicare Beneficiaries
New HRA Forms for Requesting Budget Changes or Makiing a Change on a Case
Update on 2020 Budget Changes - Lookback and Home Care Changes
COVID-19 Updates
New Articles on NYHealthAccess.org

Jan. 14, 2021 - New "Supplement A" form used in NYC, Update on "Lookback" for Community-Based LTC, Reminder on new Lock-In rule for MLTC and Disenrollment from MLTC Plans of Members in Nursing Homes for 3+ Months

2020

Sept. 30, 2020 Big Changes in Home Care Eligibility and Assessment;

Over 15,000 People Disenrolled from their MLTC Plans Because in Nursing Homes for more than 3 Months
NYLAG Submits Comments on How the new Lookback and Home Care Changes will be Implemented
New LOCK-IN Rules Start Dec. 1, 2020

July 19, 2020 Mass Expulsion of MLTC Members in Nursing Homes from MLTC plans and updates re New Lookback

Updates about the August 1st disenrollment from MLTC plans of nearly 20,000 people who have been in nursing homes for more than three months, and update on how the new "lookback" will be implemented for MLTC and other home care and Assisted Living Program.. enacted in the NYS Budget.. more info on other budget changes here

June 11, 2020 - The Discontinuance of 32,000 Medicaid Cases and More Covid-10 News

April 3, 2020 - Devastating Medicaid Cuts Enacted in NYS Budget

Medicaid cuts - a 2.5 year "lookback" imposed for financial eligibility for home care, Assisted Living Program, MLTC and other community-based long term care services and restricted eligibility criteria for Medicaid personal care and CDPAP services, with new task-based assessment tool to be developed, extra reviews for approval of high-hour care, and outside utilization reviewer to be appointed.

April 2, 2020 - New Covid-19 Resources on NYLAG website and NYHealthAccess.org

Announcing new Covid-19 resources for consumers on multiple topics and for advocates about Medicad

March 2020 NYS BUDGET MEDICAID ALERT - Medicaid cuts to eligibility and home care services proposed by the Medicaid Redesign Team (MRT) II proposed to be adopted in NYS Budget due to be finalized April 1, 2020

January 2020 Update

1. People in Nursing Homes “Long-Term” to be Disenrolled from MLTC Plans in early 2020 – and No New Enrollment in MLTC for People in Nursing Homes

2. CMS Also approved MLTC “Lock-In”

3. Governor Cuomo announced his proposed State Budget for 2020-21

2019

Oct. 10, 2019 E-Lert

The FIDA Program is Closing December 31, 2019
October 1, 2019 – Phase 2 of Cap on Number of Licensed Home Care Services Agencies each MLTC plan may contract with
CDPAP Rate Cuts - As reimbursement cuts go into effect, lawsuit challenge continues
PLAN CLOSINGS: Update on Rights of Former Members of ICS, Guildnet, and UnitedHealth
Medicare Part D Annual Enrollment Period Begins Oct. 15, 2019

Jan. 17, 2019 E-Lert

ICS to Close March 31, 2019;
New MLTC "Lock-in" rule and carve-out of permanent nursing home residents from MLTC on hold pending CMS approval
New materials available on supplemental needs trusts and impact of lump sums on Medicaid and other public benefits
2019 Medicaid income levels posted

2018

Oct. 31, 2018 E-lert - Guildnet MLTC and 4 FIDA Plan Closing Letters Sent to over 8000 Members; Reminder to register for Nov. 14th CLE; More on State Proposal to CMS to Carve Nursing Home Care out of MLTC

Sept. 27, 2018 E-lert --

1. Guildnet MLTC, FIDA & MAP Plans Closing Set for Jan. 1, 2019; UnitedHealth MLTC Plans to close UPSTATE Feb 2019;

2. MLTC Plans End Contracts with Some Home Care Agencies to Comply with 2018 State Budget Changes

3. Register for Legal Education Program on MLTC and NYS Medicaid Changes in 2018 - Nov. 14th - Conducted by NYLAG Evelyn Frank Legal Program

4. NYS Medicaid Dental Services to Expand After Lawsuit Filed by The Legal Aid Society

August 29, 2018 E-Lert

Guildnet Announces Closing of MLTC Plan - and ICS May Follow --Consumers Need to Know Their Rights When Plans Close
State Moves to Implement MLTC Changes Enacted in 2018 State Budget - New "Lock-In" Rule will Bar Members from Changing Plans after 90 Days
New Alerts & Revised "Spousal Refusal" Form from HRA Medicaid Program

April 26, 2018 E-lert      NYLAG Webinar on New Appeal Rules for MLTC and Medicaid Managed Care Available Free for
                                      Online viewing; Tips on Filing Plan Appeals - New rules for confirming oral requests in writing and
                                      for who is authorized to request an appeal

April 11, 2018 E-lert -- Reminder to Register for April 18th Webinar CLE on Changes in Appeal and Fair Hearing Rights in
MLTC and Managed Care Plans; News about Medicaid Changes Enacted in 2018-19 State Budget

March 28, 2018 E-Lert - Update on the new "Exhaustion" Requirement for Appeals of MLTC and Managed Care Plan actions; NYS Seniors May Lose Medicaid if they do Not Enroll in Medicare -- 2,204 in NYC Already Lost Medicaid but were Restored Temporarily This Month

2017

2017-12-28 E-Lert - "Exhaustion" of Internal Appeals to be required for MLTC and Medicaid Managed Care March 2018; new "SNT Notification Bill" Passed in NYS; 5 FIDA Plans closing; Medicaid Recipients age 65+ Must Enroll in Medicare or Risk Discontinuance of Medicaid

2017-10-17 E-Lert New DOH MLTC Policy 17.02 on Plan Closings - Continuity of Care Requirements apply to Guildnet & Northshore LIJ MLTC closings; Court Decisions on 24-hour live-in care; Reminder re Part D Enrollment Period, Other News

2017-05-23 E-lert - NYS 2017-18 Budget News - Spousal Refusal Intact, Cuts in Medicaid Nursing Home Bed Hold Payments; Update on Guildnet MLTC Leaving 3 Counties, Elderplan/HomeFirst Announces Leaving Suffolk County

2017-04-27 E-Lert - Guildnet MLTC Leaving 3 Counties; Report on How QMB Beneficiaries Could be Better Identified - written by EFLRP attorney Peter Travitsky and sponsored by Justice in Aging, NYS Budget Update

2017-03-24 E-Lert - How Proposals to Repeal ACA will Affect Older New Yorkers - Let Congress Know you Oppose Cuts in Medicaid and Health Insurance!

2017-02-28 E-Lert - Announcement of Seminar on MLTC for Aging LIfe Care Assn. and FIDA Expanding to Suffolk and Westchester Counties

2016

2016-Dec. 28th E-lert MLTC Update and Last Chance to Give in 2016 (Includes news that Conflict Free assessment good for 75 days instead of 60, Centerlight MLTC plan closing, New DOH MLTC policies help consumers, and FIDA extended 2 years

2016-Nov. 22nd E-Lert #Giving Tuesday! Please Support the NYLAG Evelyn Frank Legal Resources Program!

2016-August 8th E-Lert: New Fast Track Procedures for Medicaid Home Care Applications and Report on Fair Hearings
regarding MLTC Reductions in Hours - with links to New York Times coverage.

2016-March 31st E-Lert and Webinar Series Announcement (Corrected April 5, 2016)

CORRECTION: The e-lert sent March 31, 2016 said that NO payment would be made for Medicare co-insurance for QMB enrollees in Medicare Advantage Plans if the Medicaid rate for the service is lower than the Medicare rate for the service, which is usually the case. The final budget provides that the provider will be paid 85 percent of the Medicare co-insurance due. Since this applies to Medicare Advantage plans, most plans charge a flat copayment and not co-insurance. Click on the corrected e-lert for an example. n a partial victory for consumers, this payment will be made regardless of whether the Medicaid rate is lower than the Medicare rate.