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NYLAG Webinar on Exhaustion and MLTC Appeals - PowerPoint April 18, 2018 Download
Exhaustion Webinar - CLE NYLAG 4-19-2018.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
17 Apr, 2018 525 kb Downloads: 47
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 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/
16 Apr, 2018 261 kb Downloads: 595
NYS Dept. of Health Webinar Powerpoint about New Appeals Rules in Managed Care and MLTC that Start May 1, 2018 Download
Public Informational Webinar 42 CFR 438 Service Auth and Appeals March 2018.pdf
Powerpoint from a public webinar DOH held on Mar. 28 and 30, 2018. DOH has stated that the webinar and slides will be posted for viewing, but as of April 11, 2018 they are not yet posted. As a public service NYLAG is posting the slides from the presentation.
11 Apr, 2018 311 kb Downloads: 87
NYLAG Webinar CLE Announcement on "Exhaustion" - New Managed Care Appeal System - April 18, 2018 Download
Exhaustion Webinar - CLE Registration Form.pdf
Changes in federal Medicaid regulations will take effect in New York State May 1, 2018. These changes affect over 4.7 million New Yorkers -- all members of Medicaid Managed Long Term Care (MLTC) Plans and “mainstream” Medicaid managed care plans. If the managed care or MLTC plan denies or reduces a service after May 1, 2018, the member will be required to request an internal “Plan Appeal” first, and wait for the plan’s decision, before they request a Fair Hearing with the NYS Office of Temporary & Disability Assistance. In other words, they are required to “exhaust” the internal plan appeal before requesting a fair hearing. See more info about the new rule here -- http://www.wnylc.com/health/entry/184/.

The CLE will explain the new rule and its limited exceptions, and the new appeal process. It will also cover the new requirements for the plan member to “authorize” a representative to request a plan appeal or a fair hearing.

WHO: The CLE is sponsored for lawyer, paralegals, and other professionals working or volunteering in the non-profit sector, including social workers who assist seniors and people with disabilities in accessing Medicaid services.

CLE: The New York Legal Assistance Group has been certified as an Accredited Provider of Continuing Legal Education. 1.5 Professional Practice credits and .5 Skills credits have been authorized for this session. This course is appropriate for both newly admitted and experienced attorneys. CLE credit will not be available for future viewing of the recorded webinar.

COST: Free for those working in or doing pro bono work for a non-profit legal services, advocacy, or social services organization. Private lawyers and geriatric care managers are asked for a suggested donation of $75 per session
27 Mar, 2018 260 kb Downloads: 373
Currency Conversion Worksheet for Holocaust Reparations Download
Reparation worksheet.xls (2-2018).xlsx
Use this worksheet to convert lifetime total amount received in Holocaust reparations / restitution from foreign currencies (Deutschmarks and Euros) into U.S. Dollars. This is for purposes of taking advantage of the exemption of saved reparations payments from the resource test for Federally-funded means-tested benefits, like Medicaid and Supplemental Security Income.
26 Mar, 2018 148 kb Downloads: 3840
Most downloaded
Medicaid income and resource levels - 2018 Download
2018 Income and Resource Levels (March 2018 with 2018 FPL).pdf
NYC HRA Form MAPDR-01
2018 NYS Income and Resource Standards and Federal Poverty Levels (FPL)
Dated 3-20-2018 with 2018 Federal Poverty Levels for MAGI limits, MBI-WPD, MSP, etc.
24 Mar, 2018 91 kb Downloads: 322890
NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2017 Download
2001_to_2017_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2017. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
03 Jan, 2018 3.14 mb Downloads: 259448
Medicaid Eligibility in 2014 Download
Understanding MAGI & the Marketplace.pdf
Training provides framework for understanding the changes to Medicaid effective 2014, including: new categories, new income levels, new budgeting and new benefits.
15 Nov, 2013 1.56 mb Downloads: 202496
Directory of MICSA (NYC Medicaid) Contacts - August 2013 Download
MICSA Directory (08-06-13).pdf
NYC Medicaid office moved from 330 West 34th Street to 785 Atlantic Avenue, Brooklyn NY 11238 in May 2013. Contact numbers at that office listed in this document.
15 Aug, 2013 3.07 mb Downloads: 195922
Medicaid Spend-Down Training Outline Download
spendownOUTLINE09.pdf
Comprehensive outline published by Selfhelp, covering the many strategies for obtaining Medicaid coverage in New York through the Excess Income Program. Updated 5/29/09.
19 Jul, 2010 279 kb Downloads: 172304

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