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Found 7 result(s) | Articles | Files | News
item Webinar on Changes Coming May 1st in Fair Hearing Rights for MLTC and Managed Care Members - Recording Available for Online Viewing
... Exhaustion" requirement) The biggest change for ... managed care members is the "Exhaustion" requirement. Members must "exhaust" the ... decision. This is called "deemed exhaustion ...
22 Apr, 2018
item Coming July 1st: MLTC Members May Request Fair Hearing Without first Requesting Internal Appeal from Plan ("Exhaustion" Requirement ELIMINATED)
... Term Care Appeals System Change Exhaustion Requirement to be Eliminated Effective ...
11 Jun, 2015
item Notice About Elimination of Internal Appeal Requirement Download
ElderServe exhaustion of internal appeals eliminated 7-1-15_Redacted.pdf
Sample notice received by MLTC enrollees (partial cap plans only) in June 2015 explaining that internal appeals are no longer required when a plan takes adverse action.
11 Jun, 2015
item 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...
16 Apr, 2018
item Exhaustion of MLTC Plan Appeals before Requesting a Fair Hearing - NYSBA Elder Law and Special Needs Journal article 2018 Download
BogartElderLawJournalSpring18.pdf
Exhaustion of MLTC Plan Appeals Before
12 Dec, 2018
item 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
item Appeals & Grievances in Managed Long Term Care - "Exhaustion" of Plan Appeal Required since 2018
... Medicaid managed care regulations requiring "exhaustion" of Plan Appeals prior to ... Fact Sheet by NYLAG EFLRP. "Exhaustion of MLTC Plan Appeals Before ... Fact Sheets On the New Exhaustion Requirement - and MODEL NOTICES, ...
31 May, 2023
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