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2018-19 NYS Proposed Budget Would Abolish "Spousal Refusal," Cut "Spousal Impoverishment" and Change MLTC in Ways that May Hurt Consumers with High Needs
09 Feb, 2018
While we are grateful that the Governor recognizes the importance of the Medicaid program for New Yorkers, and has fought to maintain access to health care for New Yorkers under the Affordable Care Act and for DACA immigrants, the proposed New York State budget for 2018-19 includes some alarming...
MLTC UPDATE 2018 - Prepare for April 1, 2018 Changes in Fair Hearing Appeal Rights
09 Feb, 2018
This is a running news article with updates on Managed Long Term Care in NYS. Please see archives for past articles: MLTC updates 2014 - 2016 MLTC Updates - 2012 - 2013 KEY CONTACTS State Dept. of Health Complaint Number for MLTC Problems - 1-866-712-7197 or e-mail...
Heads Up - Changes Coming in Fair Hearing Rights for MLTC and Managed Care Members - April 2018
30 Jan, 2018
February 8, 2018 update - The State Dept. of Health has a new webpage on which FAQs, webinars, and guidance for mainstream Medicaid managed care plans is posted on the new requirements that start April 1st. Here is the webpage Service Authorization and Appeals for Mainstream Medicaid Managed...
30,000 NYS Residents Age 65+ May Lose Medicaid If They Do Not Apply to Enroll in Medicare - 4000 Upstate Already Discontinued
24 Jan, 2018
January 2018 UPDATE: 4,000 Upstate Medicaid Recipients age 65 have already had Medicaid discontinued effective Jan. 1, 2018 under this new requirement! In NYC, a corrected letter was sent on Jan. 6, 2018 to 5,500 recipients, extending their deadline to submit proof that they applied for Medicare...
News from NYLAG Evelyn Frank Legal Resources Program - Library of Past Newsletters
28 Dec, 2017
The Evelyn Frank Legal Resources Program at NYLAG sends out periodic updates to interested people about developments in Medicaid in New York State affecting seniors and people with disabilities, with an emphasis on people who rely on Medicaid for long-term care services or for subsidies to help...
Pooled Trust Notification Bill Signed into Law! Thanks to Assembly Health Chair Gottfried and State Senator Rob Ortt!
26 Dec, 2017
On Monday, December 18, 2017, Governor Andrew Cuomo signed into law the "Pooled Trust Notification Bill." This legislation will require for the first time that Medicaid applicants and recipients who have a spend-down be given notice in plain language that explains the availability of supplemental...
FIDA: 5 plans exit FIDA 2018 -Know Transition Rights for 534 Members of Closing Plans
26 Dec, 2017
CONTACT: NY Medicaid Choice for information or to Enroll 1-855-600-FIDA (1-855-600-3432) TTY: 1-888-329-1541 FAX a 1-917-228-8601 Monday to Friday 8:30 am to 8:00 pm and Saturday from 10:00 am to 6:00 pm. ICAN - NYS Ombudsprogram for MLTC and FIDA. Click here for info. ...
Governor Signs Law Ensuring Free Access to Health Records for Those in Need
14 Sep, 2017
In a huge win for disabled New Yorkers, a bill (A7842/S6078) that will streamline the process for thousands of New Yorkers needing to obtain their own health records has been signed into law by Governor Andrew Cuomo. Accurate and comprehensive health records are needed for applications to Social...
Trump-Care: Info re Proposals to Repeal ACA and Cut Medicaid
23 Mar, 2017
Efforts are moving ahead not only to repeal the Affordable Care Act - with or without a replacement - but to alter the Medicaid program for millions of people, including seniors and people with disabilities, by changing it from an "entitlement" program to block grants or "per capita caps." ...
MLTC Update 2016 - Centerlight MLTC to close Feb 2017, New State policies clarify assessments of hours, Minimum Wage increases funded for home care
22 Dec, 2016
KEY CONTACTS State Complaint Number for MLTC Problems - 1-866-712-7197 or e-mail mltctac@health.ny.gov Request Conflict-Free MLTC Assessment - needed to enroll in an MLTC plan call NY Medicaid Choice at 1-855-222-8350 complaints re Conflict-Free...
Fast-Tracking of Medicaid Applications for those with Immediate Need for Medicaid Home Care - DOH issues Q&A,HRA Launches New Procedure and Form
28 Oct, 2016
On Oct. 24, 2016 - NYS DOH issued a Q & A about the new Immediate Need Procedure - 2016 LCM-02 - Immediate Need for Personal Care Services and Consumer Directed Personal Assistance Program (CDPAP). The Q&A clarifies that the local district is required to process the Medicaid application...
NYLAG Evelyn Frank Program 5-Part Webinar Series on Medicare & Medicaid Available Online - Free Viewing
11 May, 2016
The Evelyn Frank Legal Resources Program just completed its five-part Continuing Legal Education Webinar program that provides tools to understand and navigate the complex world of Medicare and Medicaid in New York. The focus is on eligibility and application procedures for older persons and...
Final NYS Budget 2016-17 - Harsh Medicaid Cuts Avoided
04 Apr, 2016
In the final New York State Executive Budget effective for the fiscal year beginning April 1, 2016, most of the harshest cuts to Medicaid eligibility that Gov. Cuomo had proposed were not enacted. The Medicaid budget language is in the Health and Mental Hygiene (HMH) (S6407-C/A9007-C)- find it...
Delivery System Reform Incentive Payment (DSRIP): What You Need to Know about New York’s Changes to Medicaid
17 Mar, 2016
DSRIP restructures the current Medicaid delivery system with the ultimate goal of reducing avoidable hospital admissions by 25%. This is accomplished by putting an emphasis on the use of primary care, and providers using a data sharing system so that all of a person’s providers can share...
ALERT: Some Immigrants Who Were on Medicaid Lost Their Health Coverage January 1st
12 Jan, 2016
ALERT Some Immigrants Who Were on Medicaid Lost Their Health Coverage January 1st Some immigrant adults who had Medicaid through the Marketplace lost their Medicaid coverage on January 1, 2016 and now have no health insurance. Most of these individuals are eligible for the Essential...
Coming July 1st: MLTC Members May Request Fair Hearing Without first Requesting Internal Appeal from Plan ("Exhaustion" Requirement ELIMINATED)
11 Jun, 2015
Managed Long Term Care Appeals System Change Exhaustion Requirement to be Eliminated Effective July 1, 2015 Since early June 2015, everyone in Managed Long Term Care (MLTC) plans have been receiving a notice from their MLTC plan that looks like this sample notice. This notice has caused a lot...
NYS BUDGET for 2015-2016 Again Proposes End to Spousal Refusal and "Immediate Need" Medicaid
12 Feb, 2015
The Governor's proposed New York State budget for 2015-16 includes some good and some bad for health care for low-income New Yorkers. Click here to see the actual Health and Mental Hygiene (HMH) Bill and the Governor's Health and Mental Hygiene (HMH) Memorandum in Support. NYLAG is one of many...
Mandatory Enrollment of Nursing Home residents into Managed Care & MLTC - scheduled to begin Feb. 1, 2015
27 Jan, 2015
Nursing Home Resident Transition to Managed Care February 1, 2015 marks the start date for the new requirement for nursing home residents who became "permanent" residents after that date to enroll in managed care or MLTC plans. CMS approved this expansion of MLTC and mainstream Medicaid managed...
Consumer Advocates Call for Further Protections in Medicaid Managed Long Term Care
01 Sep, 2014
Consumer advocates have submitted several comments to the New York State Department of Health and the Centers for Medicare and Medicaid Services (CMS) that would protect the rights consumers as Managed Long Term Care is implemented. September 2014 - NYLAG, Empire Justice Center and other...
Providers Must be Enrolled in NYS Medicaid Program to ORDER/PRESCRIBE/REFER/ATTEND Medicaid Services
03 Jul, 2014
Physicians and other healthcare providers are required to enroll with the NY State Medicaid program before Medicaid will pay for services that the providers prescribe, order, or refer. The rule applies to ordering, prescribing, referring and attending physicians and healthcare providers (“OPRA...

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