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NYLAG Training Presentation: Managed Long Term Care: Status in 2014 and Preview of FIDA Download
NYLAG MLTC PowerPoint 4-22-14.pdf
PowerPoint presentation used in NYLAG's webinar on 4/24/14 to HIICAP and others.
24 Apr, 2014 584 kb Downloads: 3206
Consumer Coalition May 2013 Letter on Changes in Proposed Dual Eligible "FIDA" Demonstration Waiver Download
CPRNYDE comments re addendum May 2013.pdf
Coalition to Protect the Rights of NYS Dual Eligibles Comments on State's revised proposal to coordinate Medicare and Medicaid services for dual eligibles, letter dated May 19, 2013. Issues include enrollment of nursing home residents and protections; objections to "passive enrollment" -- auto-assignment of people who don't voluntarily enroll; and incentives for plans to provide long term care services in the community rather than institutions.
18 Mar, 2014 88 kb Downloads: 1145
NYLAG Support of NY Assembly Bill A4996 - Correcting Violations of Due Process Appeal RIghts in Managed Care Download
A4996 Gottfried MLTC Appeals Bill NYLAG 2014 FINAL.pdf
This bill would correct two due process violations: (1) The lack of "aid continuing" pending an appeal when a managed care plan reduces or terminates home care or other services -- if the "authorization period" for the services has expired, there is a right to appeal but no right to aid continuing. This provides that aid continuing must be given regardless of whether the authorization period has expired. (2) In Managed long term care, consumers must "exhaust" internal appeals before requesting a hearing. This is not required in mainstream managed care, and results in dismissal of many valid appeals because consumers don't know that they must pursue this interim internal appeal.
18 Mar, 2014 202 kb Downloads: 1317
Consumer Advocacates Letter to DOH & CMS 3-14-14 - Asking for Delay on Managed Care Expansion to Nursing Home Population Download
NH Carve in Consumer Concerns 3-14-14.2.pdf
14 Mar, 2014 544 kb Downloads: 1790
NYS Bar Association Elder Law Section Letter to NYC HRA Dec. 17 2013 - Spousal Impoverishment Allowances Illegally Denied Download
NYCHRA_NYSBA_Letter spousal budgeting 2013-12-17 REDACTED.pdf
Letter to HRA to cease the unlawful practice of denying this impoverishment income allowance to community spouses who did a spousal refusal. HRA responded and corrected its policy, provided spouse provides complete information regarding income and resources. For links to these documents and to the letters from the NYSBA and HRA, see http://www.wnylc.com/health/entry/96/
04 Mar, 2014 178 kb Downloads: 3102
Medicaid Reimbursement for Home Care Expenses Download
Medicaid Homecare Reimbursement.pdf
Practical Guide on getting Medicaid to reimburse for home care expenses incurred during the 3-month retroactive period, and during the pendency of the application, in New York City. Includes citations to pertinent case law and regulations.
03 Mar, 2014 319 kb Downloads: 12406
Affidavit to request reimbursement of home care expenses paid in cash Download
Homecare Reimbursement Affidavit NEW.dot
Sample unofficial form affidavit, created by NYLAG in consultation with NYC HRA Reimbursement Unit.
03 Mar, 2014 30 kb Downloads: 3823
Preserve "Spousal Refusal" in NYS - Statement of Coalition to Protect the RIghts of NY's Dually Eligible Download
CPRNYDE Spousal Refusal - 2014-2015 Budget FINAL.pdf
Opposing Governor's Budget proposal for SFY 2014-15
05 Feb, 2014 574 kb Downloads: 1327
Consumer Coalition Letter to NYS and Federal CMS to Nov. 27, 2013 with Comments on Three-Way Contract for FIDA Download
CPRNYDE letter to MMCO and NYSDOH re Contract Priorities FINAL 11-27-13 .pdf
After the Federal CMS agency entered a "memorandum of understanding" with NYS to approve the FIDA proposal to manage care for Dual Eligibles, a 3-way contract had to be approved between the State, the Feds and the FIDA plans. THis is the consumer coalition's comments on what protections are needed in this contract.
16 Jan, 2014 117 kb Downloads: 1743
Consumer Advocacy Position Paper on Promoting Community-Based Incentives for Managed Long Term Care in NYS Download
Incentives for Com-Based Services in NYS MLTC 032312.pdf
Paper dated March 23, 2012 filed with US Center for Medicare & Medicaid Services and NYS Dept. of Health to incentivize community-based services in the roll-out to mandatory managed long term are.
20 Dec, 2013 126 kb Downloads: 3090
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