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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: 589
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: 356
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: 603
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: 268869
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: 799
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: 902
State DOH Letter to Former Guildnet Members in LI, estchester 9-29-17 - May ask to Restore Hours Download
2017.10.16 DOH letter Guildnet redacted updated.pdf
Letter from State DOH to people who were in Guildnet MLTC plan in Nassau, Suffolk and Westchester counties and moved to another plan after Mar. 20, 2017. They must call NY Medicaid Choice before Dec. 29, 2017 to ask for their hours to be restored to the amount Guildnet had authorized, if the new plan reduced their hours.
16 Oct, 2017 81 kb Downloads: 834
Letter from State Dept. of Health to Guildnet members in Long Island & Westchester - 3/13/2017 Download
guildnet letter from DOH - 2 - May 2016.pdf
Letter dated Mar. 13, 2017 from NYS Dept of Health to 4000+ members of Guildnet MLTC in Suffolk, Nassau, and Westchester counties, clarifying that Guildnet MLTC is not closing in those 3 counties on June 1, 2017 and that the plan is required to continue providing services to members after that date. See letter for more.
18 May, 2017 654 kb Downloads: 1032
NYS Personal Care Aide Scope of Practice Download
Personal Care Aide Scope of Practice 12-1994.pdf
NYS Dept. of Social Services Local Commissioners Memorandum 92-LCM-70, DSS-4037-EL, April 24, 1992. Amended December 1, 1994. Describes which tasks personal care aides (known as home attendants in NYC) may and may not do.
16 May, 2017 116 kb Downloads: 22343
Letter Template from Guildnet in Nassau, Suffolk and Westchester to Members - Feb. 2017 Download
GuildNet plan withdrawal - member notification letter 3 counties combined.pdf
Letter Guildnet is sending to it;s 4,000+ members in Nassau, Suffolk and Westechester counties in Feb and March 2017 stating, "GuildNet will no longer offer Managed Long Term Care (MLTC) services in [county] effective June 1, 2017. It is important that you select a new MLTC plan before May 18, 2017 to assure a smooth transfer to your new plan. You will continue to receive services from GuildNet until your transfer to your new plan is complete." Letter does not explain that if person does NOT transfer to another plan, they may still stay in Guildnet. Nor does letter explain that new plan is not required by State to honor Guildnet's same plan of care and number of hours. NOr does letter give contact info for ICAN ombuds program. icannys.org
29 Mar, 2017 263 kb Downloads: 1463
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