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State DOH Templates for MLTC Denials, Reductions, Terminations - effective July 1, 2015 Download
New MLTC Notices of Adverse Action - June 2015.pdf
Combined in one PDF is March 2015 State directive to MLTC plans requiring use of new templates for notifying member of reductions, denials, and terminations of services. Templates should be used by mid-May 2015. PDF includes Directive plus TWO new notice templates and the state's EXAMPLES of how the two templates are used. Also included is a sample of notice that MLTC plans sent to all members in June 2015 notifying of elimination of requirement to "exhaust" internal appeals before requesting fair hearing
25 Jun, 2015 1.2 mb Downloads: 39985
MAP-648 P SUBMISSION OF REQUEST FROM RESIDENTIAL HEALTH CARE FACILITIES (RHCF) Download
MAP-648P NH MA Transmittal 6-2015.pdf
Transmittal form used by HRA Medicaid where the Nursing Home provides HRA with streamlined information about the applicant and the applicant's request for Nursing Home Medicaid coverage.
18 Jun, 2015 147 kb Downloads: 4626
Notice About Elimination of Internal Appeal Requirement Download
ElderServe exhaustion of internal appeals eliminated 7-1-15_Redacted.pdf
Sample notice received by MLTC enrollees (partial cap plans only) in June 2015 explaining that internal appeals are no longer required when a plan takes adverse action.
11 Jun, 2015 296 kb Downloads: 1524
Number Enrolled in Each FIDA and MLTC plan in FIDA Demo Area - April - May 2015 Download
MLTC and FIDA Enrollment April May 2015 FIDA plans only.xlsx
Data compiled from CMS site https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-Enrollment-by-Plan-Items/Monthly-Enrollment-by-Plan-2015-05.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending

and DOH site http://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/
01 Jun, 2015 16 kb Downloads: 2053
MAPDR-05 (05/28/2015) List of Managed Care & Managed Long Term Care Plans in NYC Download
2015-05-28 MAP DR-05 Provider ID Numbers and Plan Codes.pdf
This includes a list of all managed care organizations participating in the following types of Medicaid managed care, including ID and code numbers, contact information, and service areas:
* Medicaid Managed Care
* Medicaid Advantage (for dual eligibles)
* Managed Long Term Care (MLTC)
* Medicaid Advantage Plus (for dual eligibles, includes MLTC)
* HIV Special Needs Plans (SNP)
* Programs of All-inclusive Care for the Elderly (PACE)
* Fully Integrated Dual Advantage (FIDA)

Updated May 28, 2015
01 Jun, 2015 164 kb Downloads: 39695
Form M-11q - Medical Request for Home Care (12-9-014) Download
HCSP-M11q (12-9-2014)Fill-in-able.2.pdf
This is the form used by the New York City Human Resources Administration for doctors to request personal care services through Medicaid for people who are excluded or exempt from Managed Long Term Care. This means it is for people in the OPWDD, TBI or NHTDW waivers, who require only Housekeeping services of up to 8 hours/week or who are under age 21. The form was updated 12/2014. This is a fillable version. THe original PDF can be downloaded at http://www.nyc.gov/html/hra/downloads/pdf/services/micsa/m_11q.pdf.
21 May, 2015 137 kb Downloads: 37713
Statewide Contact list of MLTC-MAP-PACE plans by County Download
STATEWIDE LIST OF Managed Long Term Care 6 and 4-2015.pdf
Statewide Contact list of MLTC-MAP-PACE plans by County from http://www.health.ny.gov/health_care/managed_care/mltc/mltcplans.htm - updated with April. 2015 enrollment data
13 May, 2015 526 kb Downloads: 22327
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 Download
Appendix Final.pdf
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 - includes helpful lists of plans, forms, and a Troubleshooting guide.
27 Apr, 2015 2.24 mb Downloads: 16201
PowerPoint Presentation by NYLAG Evelyn Frank Program on FIDA and MLTC 4/23/2015 Download
2015 NYLAG CLE MLTC-FIDA updated 4-23-2015.pptx
PowerPoint Presentation by NYLAG Evelyn Frank Program on FIDA and MLTC 4/23/2015.
Updated version of presentation in live CLE conducted APril 20, 2015
27 Apr, 2015 1.89 mb Downloads: 2695
Presentación de Powerpoint Sobre FIDA y MLTC Download
Caregiver Presentation Spanish Final 4-13-15.pdf
Esta presentación fue realizada el 13 de Abril 2015 en una organización local en Brooklyn para los residentes de ese edificio. La presentación es en español. Esta presentación se enfoca en los temas de Medicare, Medicaid, planes de cuidado a largo plazo (MLTC), y planes de doble ventaja totalmente integrado (FIDA).

Debe de usar estos materiales con la grabación sobre FIDA.

This presentation took place on April 13th, 2015 for local Brooklyn residents residing in senior housing. The presentation was conducted in Spanish. The presentation discussed Medicare, Medicaid, Managed Long Term Care plans (MLTC), and Fully Integrated Dual Advantage plans (FIDA).

Please view the powerpoint in conjunction with the Spanish recording of the presentation.
27 Apr, 2015 355 kb Downloads: 1293
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