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NYS Dept. of Health Letter to local Medicaid agencies about Counseling Medicaid Recipients about Public Charge Download
NYS Dept. of Health 10-18-19 Letter to Local Commr's re Public Charge.pdf
Letter from the NYS Dept. of Health instructing local Medicaid agencies about how to identify recipients who are EXEMPT from the proposed public charge changes, in order to counsel recipients who call to close their Medicaid cases out of fear of jeopardizing their immigration status. Letter also suggests referring callers to the NYS Office for New Americans at 1-800-566-7636
27 Oct, 2019 696 kb Downloads: 140
State Model " Non-Passive Enrollment" Notice #2 Sent to Members of Only TWO FIDA Plans that FIDA Closing Download
Final FIDA Non-Renewal Model Letter - Non-Passive Enrollment - 09.25.19 ORIGINAL.PDF
Final FIDA Non-Renewal Model Letter - "Non-Passive Enrollment" - "Notice 2" 09.25.19
State Template for notice sent to members of only TWO FIDA plans -- Riverspring and those in Senior Whole Health FIDA who live OUTSIDE the Bronx. The notice says the FIDA program is closing Dec. 31, 2019. This notice tells members of these plans that unless they select a different plan before Dec. 20, 2019, they will be assigned to a Managed Long Term Care plan operated by the same company that operates their FIDA plan. If they do nothing, these members will be assigned not only to an MLTC plan but also randomly assigned to a Medicare Part D drug plan, and enrolled in Original Medicare January 1, 2020.

Members of the other 4 FIDA plans and those in Senior Whole Health who live in the Bronx received "Notice 1" - Passive Enrollment notice, posted at http:// www.wnylc.com/health/download/703/
07 Oct, 2019 340 kb Downloads: 115
State Model "Passive Enrollment" Notice (1) Sent to Members of Most FIDA Plans that FIDA Closing Download
Final FIDA Non-Renewal Model Letter - Passive Enrollment - 09.25.19 ORIGINAL.PDF
State Template for "Notice 1" or "Passive Enrollment" notice sent to members of most FIDA plans that FIDA program is closing Dec. 31, 2019. This notice tells members in this group that unless they select a different plan before Dec. 20, 2019, they will be assigned to the Medicaid Advantage Plus(MAP) plan operated by the same company that operates their FIDA plan. This "Notice 1" sent to members of all FIDA plans EXCEPT Riverspring, and for those in Senior Whole Health FIDA, only members who live in the Bronx received this notice.
07 Oct, 2019 309 kb Downloads: 82
Letter to Members of ICS Jan. 25, 2019 from NYS Dept. of Health re Options for Plan Closing effective April 1, 2019 Download
ics-closure-notice-redacted.pdf
"Official" closing letter to members of the ICS Managed Long Term Care (MLTC) Plan from the NYS Dept. of Health dated Jan. 25, 2019 explaining that those members who did not choose to enroll in an MLTC plan by Mar. 20, 2019 would be assigned to VNS Choice MLTC plan eff. 4/1/19. Letter explains one-year continuity protections at VNS only, and new ICS Health Home that will continue to manage care for some ICS members who transfer to VNS. See http://www.wnylc.com/health/news/78/.
04 Mar, 2019 135 kb Downloads: 605
NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2018 Download
2001_to_2018_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2018. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
02 Jan, 2019 3.24 mb Downloads: 282932
Update: New York State Medicaid Program Dental Policy and Procedure Code Manual Download
2018-11 updates to Dental Manual.pdf
Update eff 11/12/2018 on implants and replacement of dentures. Policy change results from lawsuit filed in August 2018,
Ciaramella v. Zucker (18-cv-06945), by The Legal Aid Society and Willkie Farr & Gallagher. See http://www.wnylc.com/health/entry/210/
21 Sep, 2018 111 kb Downloads: 2289
Form DOH-5247 - Medicaid Authorized Representative Designation/Change Request Download
DOH-5247 - Medicaid Authorized Rep Designation - Change Request (10-2017).pdf
Form for Medicaid applicant or recipient to designate or change representative authorized to sign applications, renewals, or conduct other communications with local district
25 May, 2018 247 kb Downloads: 908
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: 1500
NYS DOH Model Managed Care/MLTC PLAN APPEAL DECISION Reducing Services - Effective March 1, 2018 Download
Final FAD With AC 11-20-17.pdf
The "Final Adverse Determination" template that NYS DOH has provided to Medicaid managed care and MLTC plans for Plan Internal Appeal Decisions affirming a proposed reduction of services. This notice must be used after March 1, 2018, when embers must first request an internal appeal and wait until that is decided before they may request a fair hearing. See more here http://www.wnylc.com/health/news/80/. This "Final Adverse Determination" will advise the member of the right to request a fair hearing with aid continuing.
26 Dec, 2017 679 kb Downloads: 1611
NYS DOH Model Managed Care/MLTC Notice Reducing Services - Effective March 1, 2018 Download
Final IAD With AC 11-20-17.pdf
The notice template that NYS DOH has provided to Medicaid managed care and MLTC plans for reducing services after March 1, 2018, on which date members must first request an internal appeal and wait until that is decided before they may request a fair hearing. See more here http://www.wnylc.com/health/news/80/. A sample of a completed notice is posted at http://www.wnylc.com/health/download/644/ - this is an unofficial sample using hypothetical facts, created by NYLAG for illustration.
22 Dec, 2017 738 kb Downloads: 1646
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