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Medicaid
Medical Loss Ratio and Percentage of Premium Spent on Various Services - MLTC Plans - 2011 Download
2011 Premium Allocation - Medical-Case Mgt-Admin- Profi.pdf
Data compiled by Evelyn Frank Legal Resources Program from MMCOR cost reports filed by plans with State Dept. of Health, released through Freedom of Information Request. Data for CY 2011
24 Apr, 2013 19 kb Downloads: 1961
Range of Hours/month of Personal Care & Home Health care provided by MLTC plans - 2011 Download
Percentage PCA-HHA Hours MLTC.pdf
MLTC Plans (Partial Capitation) by Hours of Personal Care & Home Health Aide Services Provided – 2011 (In order of highest percentage of cases > 480 hours/month)(All solely NYC unless otherwise indicated). "Member months" means month in which plan reported providing a member with Personal Care or Home Health aide services. Since many members do not receive these services for an entire calendar year, this figure is more accurate than stating the total number of members who received the specified amount of hours.

Data compiled from MMCOR Reports filed by plans and disclosed to Evelyn Frank Legal Resources Program thru a FOIL request.. Full calendar year 2011.
24 Apr, 2013 25 kb Downloads: 1964
Medicare Advantage, Medicaid Advantage/ MAP/PACE/MLTC enrollment by plan in NYC Feb - March 2013 Download
Medicare Advantage-MA-MA Plus enrollment NYC 2-2013.pdf
Chart showing all Medicare Advantage, Medicaid Advantage, Medicaid Advantage Plus and PACE plans in NYS - IN NEW YORK CITY by borough, with number of Medicare beneficiaries enrolled in each plan.

Medicare Advantage data from Feb. 2013 - http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/index.html

Medicaid plan data from Mar. 2013 - monthly Medicaid Managed Care Enrollment Report - http://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/
23 Apr, 2013 11 kb Downloads: 3811
Medicare and Medicaid Managed Care for Dual Eligibles - Enrollment Penetration in Plans in NYS (Outside NYC) Download
MA Chart NYS February 2013 with MAP - MA - MLTC - Outside NYS.pdf
Chart showing all Medicare Advantage, Medicaid Advantage, Medicaid Advantage Plus and PACE plans in NYS - outside NYC by county, with number of Medicare beneficiaries enrolled in each plan.

Medicare Advantage data from Feb. 2013 - http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/index.html

Medicaid plan data from Mar. 2013 - monthly Medicaid Managed Care Enrollment Report
23 Apr, 2013 33 kb Downloads: 3572
Mandatory Enrollment of Long Term Home Health Care Program Consumers into Managed Care Download
2013-04-18 Lombardi MLTC.pdf
23 Apr, 2013 102 kb Downloads: 372
Medicaid Alert: Medical Evidence for Adult Disability Determination 1-24-13. Download
Medicaid Alert--Medical Evidence Disability 1-2013.pdf
This alert modifies the process for adult disability determinations by requiring medical records (progress notes, testing reports, hospital discharge record, etc.) in addition to the 486T form. The alert also requires three HIPPA OCA 960 forms signed and dated by the consumer. Forms included in the pdf.
21 Mar, 2013 428 kb Downloads: 22189
Social Security Verification--No Proof of SSA Income Required for Initial Applications and Renewals Download
Medicaid Alert No Proof of SSA income required 3-2013.pdf
07 Mar, 2013 337 kb Downloads: 4363
MAP3057E Special Income Standard for Housing Expenses Form Download
MAP-3057E Special income housing Expenses NH-MLTC.pdf
20 Feb, 2013 490 kb Downloads: 3078
HealthFirst CompleteCare Grievance Procedure MAP Download
Healthfirst MAP Complaint- Complaint Appeal for Long term ca.pdf
Policy obtained January 2013 through FOIL Request to DOH. Policy is undated and includes track changes.
06 Feb, 2013 59 kb Downloads: 981
Eldeplan, Inc. Grievance Policy MAP Download
Elderplan MAP GrievancesDRAFT.pdf
Policy obtained January 2013 through FOIL Request to DOH. Policy is labeled draft and undated.
06 Feb, 2013 70 kb Downloads: 2386
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