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news Mandatory Enrollment of Nursing Home residents into Managed Care & MLTC - Delayed Until at Least Oct. 1, 2014 or later
16 Sep, 2014
Nursing Home Resident Transition to Managed Care As of Sept. 16, 2014 the federal Medicaid agency CMS has still not approved the expansion of the 1115 waiver that will allow the State to require new nursing home residents to enroll in mainstream Medicaid managed care and MLTC plans. Oct. 1, 2014...
news MLTC Roll-Out – Conflict-Free Assessment Begins October, New MLTC Counties, Delayed NH Roll-out
15 Sep, 2014
State Complaint Number for MLTC Problems - 1-866-712-7197 e-mail mltcworkgroup@health.state.ny.us and put "COMPLAINT" in subject line For enrollment complaints - call NY Medicaid Choice - 1-855-886-0570 (Advocates line) 1-888-401-6582 (Consumers line) State...
news Consumer Advocates Call for Further Protections in Medicaid Managed Long Term Care
01 Sep, 2014
Consumer advocates have submitted several comments to the New York State Department of Health and the Centers for Medicare and Medicaid Services (CMS) that would protect the rights consumers as Managed Long Term Care is implemented. September 2014 - NYLAG, Empire Justice Center and other...
news CMS announces Part D Extra Help benchmark rates for 2015
05 Aug, 2014
On July 31st, CMS posted their annual release of Part D national average bid amount and other Part C&D bid-related information for calendar year 2015. In New York State, the Part D Regional Low-Income Subsidy (“benchmark”) amount will be $36.94 (down from 37.23 in 2014) De minimis...
news NYS AGAIN Delays Launch of "FIDA" Demonstration to Manage Care for Dual Eligibles - to January 2015
09 Jul, 2014
After a prior 6-month postponement announced in January 2014, New York State in July 2014 again delayed the start of its Fully Integrated Dual Advantage demonstration program until January 2015 (in NYC and Nassau Counties, April 2015 in Westchester and Suffolk Counties). The initial voluntary...

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document New Permanent Nursing Home Residents in NYS will be Required to Enroll in Medicaid Managed Care Plans or MLTC Plans - Effective Date postponed til January 2015
UPDATE As of Sept. 16, 2014 the federal Medicaid agency CMS has still not approved the expansion of the 1115 waiver that will allow the State to...
document Delays in Processing of Medicaid Applications - What are Your Rights and Lawsuits Challenging Delays
The Deadlines to Process Medicaid Applications in the Law Federal and state law set time limits for processing a Medicaid application. The federal...
document State Takes Steps to Implement Court Order Requiring Temporary Personal Care Services while Medicaid Application is Pending
A lawsuit pending for 7 years led to a court Order directing the NY State Dept. of Health to establish a procedure for certain needy Medicaid...
document How to use a pooled SNT to eliminate the Medicaid spend-down.
This memo explains how to use a Pooled Supplemental Needs Trust to eliminate the Medicaid spend-down (updated September 2014) Note that new...
document Empire Justice Center Reports on Immigrant Access to Health Care in NY's Health Insurance Exchange
The Empire Justice Center published a report in May, 2013 exploring the policies that guide immigrant access to health care and making...


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document Income and Resource Limits for New York State Public Health Insurance Programs
The Affordable Care Act changes the rules for Medicaid income eligibility for many BUT NOT ALL New Yorkers, expanding eligibility for many people...
document Medicaid Personal Care or Home Attendant Services
The Medicaid program in New York State covers a type of home care services called Personal Care Assistance (aka PCA or "home attendant"). To obtain...
document Medicaid Certified Home Health Agency (CHHA) Services
A Certified Home Health Agency (CHHA) provides what is commonly known as “visiting nurse” services, as well as physical or occupational or...
document Medicaid Spend-Down
Because Medicaid is a health insurance program for the poor, one must have income and assets below a certain limit to be eligible. For a single...
document Managed Long Term Care
Managed Long Term Care (MLTC) plans are insurance plans that are paid a monthly premium ("capitation") by the New York Medicaid program to approve...



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