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News from NYLAG Evelyn Frank Legal Resources Program - Library of Past Newsletters

06 Apr, 2021

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 with Medicare out-of-pocket costs.    "d

Here are links to past issues of our e-lerts.  

Sign up to receive periodic e-mail updates from the Evelyn Frank Legal Resources Program (select TOPIC:  Elder Law (Medicaid, long-term care) and any other topics you are interested in.

2021

April 6, 2021 -

  • Medicaid Advantage Plus (MAP) Fair Haring Mistake Affects 789 Consumers;  
  • New Default Enrollment into Dual-Special Needs Medicare Advantage Plans for new Medicare Beneficiaries
  • New HRA Forms for Requesting Budget Changes or Makiing a Change on a Case
  • Update on 2020 Budget Changes - Lookback and Home Care Changes
  • COVID-19 Updates
  • New Articles on NYHealthAccess.org

Jan. 14, 2021 -  New "Supplement A" form used in NYC,  Update on "Lookback" for Community-Based LTC, Reminder on new Lock-In rule for MLTC and Disenrollment from MLTC Plans of Members in Nursing Homes for 3+  Months

2020

Sept. 30, 2020   Big Changes in Home Care Eligibility and Assessment

  • Over 15,000 People Disenrolled from their MLTC Plans Because in Nursing Homes for more than 3 Months
  • NYLAG Submits Comments on How the new Lookback and Home Care Changes will be Implemented
  • New LOCK-IN Rules Start Dec. 1, 2020

July 19,  2020    Mass Expulsion of MLTC Members in Nursing Homes  from MLTC plans and updates re New Lookback

Updates about the August 1st disenrollment from MLTC plans of nearly 20,000 people who have been in nursing homes for more than three months, and update on how the new "lookback" will be implemented for MLTC and other home care and Assisted Living Program.. enacted in the NYS Budget.. more info on other budget changes here 

June 11, 2020 - The Discontinuance of 32,000 Medicaid Cases and More Covid-10 News

April 3, 2020 - Devastating Medicaid Cuts Enacted in NYS Budget

Medicaid cuts - a 2.5 year "lookback" imposed for financial eligibility for home care, Assisted Living Program, MLTC and other community-based long term care services and restricted eligibility criteria for Medicaid personal care and CDPAP services, with new task-based assessment tool to be developed, extra reviews for approval of high-hour care, and outside utilization reviewer to be appointed.  

April 2, 2020 - New Covid-19 Resources on NYLAG website and NYHealthAccess.org

March 2020 NYS BUDGET MEDICAID ALERT -  Medicaid cuts to eligibility and home care services proposed by the Medicaid Redesign Team (MRT) II proposed to be adopted in NYS Budget due to be finalized April 1, 2020

January 2020 Update 

       1.         People in Nursing Homes “Long-Term” to be Disenrolled from MLTC Plans in early 2020 – and No New Enrollment in MLTC for People in Nursing Homes

       2.        CMS Also approved MLTC “Lock-In” 

      3.         Governor Cuomo announced his proposed State Budget for 2020-21 

2019

Oct. 10, 2019 E-Lert

  1. The FIDA Program is Closing December 31, 2019 
  2. October 1, 2019 – Phase 2 of  Cap on Number of  Licensed Home Care Services Agencies each MLTC plan may contract with
  3. CDPAP Rate Cuts - As reimbursement cuts go into effect, lawsuit challenge continues
  4.  PLAN CLOSINGS:  Update on Rights of Former Members of ICS, Guildnet, and UnitedHealth 
  5. Medicare Part D Annual Enrollment Period Begins Oct. 15, 2019

Jan. 17, 2019 E-Lert   

  • ICS to Close March 31, 2019;
  • New MLTC "Lock-in" rule and carve-out of permanent nursing home residents from MLTC on hold pending CMS approval
  • New materials available on supplemental needs trusts and impact of lump sums on Medicaid and other public benefits
  • 2019 Medicaid income levels posted

2018

Oct. 31, 2018 E-lert  - Guildnet MLTC and 4 FIDA Plan Closing Letters Sent to over 8000 Members;  Reminder to register for Nov. 14th CLE; More on State Proposal to CMS to Carve Nursing Home Care out of MLTC 

Sept. 27, 2018 E-lert -- 

1. Guildnet MLTC, FIDA & MAP Plans Closing Set for Jan. 1, 2019; UnitedHealth MLTC Plans to close UPSTATE Feb 2019;

2.   MLTC Plans End Contracts with Some Home Care Agencies to Comply with 2018 State Budget Changes

3.   Register for Legal Education Program on MLTC and NYS Medicaid Changes in 2018 - Nov. 14th - Conducted by NYLAG Evelyn Frank Legal Program

4.   NYS Medicaid Dental Services to Expand After Lawsuit Filed by The Legal Aid Society
 

August 29, 2018 E-Lert  

  • Guildnet Announces Closing of MLTC Plan - and ICS May Follow --Consumers Need to Know Their Rights When Plans Close
  • State Moves to Implement MLTC Changes Enacted in 2018 State Budget - New "Lock-In" Rule will Bar Members from Changing Plans after 90 Days
  • New Alerts & Revised "Spousal Refusal" Form from HRA Medicaid Program

April 26, 2018 E-lert      NYLAG Webinar on New Appeal Rules for MLTC and Medicaid Managed Care Available Free for
                                      Online viewing;  Tips on Filing Plan Appeals - New rules for confirming oral requests in writing and
                                      for who is authorized to request an appeal

April 11, 2018 E-lert --   Reminder to Register for April 18th Webinar CLE on Changes in Appeal and Fair Hearing Rights in
                                      MLTC and Managed Care Plans;  News about Medicaid Changes Enacted in 2018-19 State Budget

March 28, 2018 E-Lert  - Update on the new "Exhaustion" Requirement for Appeals of MLTC and Managed Care Plan actions;  NYS Seniors May Lose Medicaid if they do Not Enroll in Medicare -- 2,204 in NYC Already Lost Medicaid but were Restored Temporarily This Month

2017

2017-12-28 E-Lert - "Exhaustion" of Internal Appeals to be required for MLTC and Medicaid Managed Care March 2018; new "SNT Notification Bill" Passed in NYS; 5 FIDA Plans closing; Medicaid Recipients age 65+ Must Enroll in Medicare or Risk Discontinuance of Medicaid

2017-10-17 E-Lert  New DOH MLTC Policy 17.02 on Plan Closings - Continuity of Care Requirements apply to Guildnet & Northshore LIJ MLTC closings; Court Decisions on 24-hour live-in care; Reminder re Part D Enrollment Period, Other News

2017-05-23 E-lert -  NYS 2017-18 Budget News - Spousal Refusal Intact, Cuts in Medicaid Nursing Home Bed Hold Payments;  Update on Guildnet MLTC Leaving 3 Counties, Elderplan/HomeFirst Announces Leaving Suffolk County

2017-04-27 E-Lert - Guildnet MLTC Leaving 3 Counties; Report on How QMB Beneficiaries Could be Better Identified - written by EFLRP attorney Peter Travitsky and sponsored by Justice in Aging, NYS Budget Update

2017-03-24 E-Lert - How Proposals to Repeal ACA will Affect Older New Yorkers - Let Congress Know you Oppose Cuts in Medicaid and Health Insurance! 

2017-02-28 E-Lert - Announcement of Seminar on MLTC for Aging LIfe Care Assn. and FIDA Expanding to Suffolk and Westchester Counties

2016

2016-Dec. 28th E-lert     MLTC Update and Last Chance to Give in 2016  (Includes news that Conflict Free assessment good for 75 days instead of 60,  Centerlight MLTC plan closing, New DOH MLTC policies help consumers, and FIDA extended 2 years 

2016-Nov. 22nd E-Lert    #Giving Tuesday!  Please Support the NYLAG Evelyn Frank Legal Resources Program! 

2016-August 8th E-Lert:  New Fast Track Procedures for Medicaid Home Care Applications and Report on Fair Hearings
                                     regarding MLTC Reductions in Hours - with links to New York Times coverage.  
 

2016-March 31st E-Lert and Webinar Series Announcement  (Corrected April 5, 2016)

CORRECTION:   The e-lert sent March 31, 2016 said that NO payment would be made for Medicare co-insurance for QMB enrollees in Medicare Advantage Plans if the Medicaid rate for the service is lower than the Medicare rate for the service, which is usually the case.   The final budget provides that the provider will be paid 85 percent of the Medicare co-insurance due.  Since this applies to Medicare Advantage plans, most plans charge a flat copayment and not co-insurance.  Click on the corrected e-lert for an example.  n a partial victory for consumers, this payment will be made regardless of whether the Medicaid rate is lower than the Medicare rate.

2015

2015-December 23rd E-lert

2015-March 25th E-lert

2014

2014 -December 18th E-lert  

2014 -November 25th E-lert

2014 -November 12th E-lert

2014 - October 9th E-lert

2014 - April 2nd E-Lert

2014 - Feb. 4th E-lert 

2013

2013 - August 20th 

2013 - March 29th

2013 - Jan. 28th 

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