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news CMS announces Part D Extra Help benchmark rates for 2015
05 Aug, 2014
On July 31st, CMS posted their annual release of Part D national average bid amount and other Part C&D bid-related information for calendar year 2015. In New York State, the Part D Regional Low-Income Subsidy (“benchmark”) amount will be $36.94 (down from 37.23 in 2014) De minimis...
news NYS AGAIN Delays Launch of "FIDA" Demonstration to Manage Care for Dual Eligibles - to January 2015
09 Jul, 2014
After a prior 6-month postponement announced in January 2014, New York State in July 2014 again delayed the start of its Fully Integrated Dual Advantage demonstration program until January 2015 (in NYC and Nassau Counties, April 2015 in Westchester and Suffolk Counties). The initial voluntary...
news MLTC Roll-Out - MLTC Expansion to Nursing Homes delayed 1 Month, Free Webinar on MLTC, New Directives Issued
08 Jul, 2014
State Complaint Number for MLTC Problems - 1-866-712-7197 e-mail mltcworkgroup@health.state.ny.us and put "COMPLAINT" in subject line For enrollment complaints - call NY Medicaid Choice - 1-855-886-0570 (Advocates line) 1-888-401-6582 (Consumers line) State...
news Mandatory Enrollment of Nursing Home residents into Managed Care & MLTC - Delayed Until at Least August 1, 2014
08 Jul, 2014
Nursing Home Resident Transition to Managed Care As of June 27th, 2014 (and presumably as of July 7th) the federal Medicaid agency CMS has still not approved the expansion of the 1115 waiver that will allow the State to require nursing home residents to enroll in managed care and MLTC plans....
news 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...

Recent Articles
 
document KNOW YOUR RIGHTS: Managed Long Term Care - Fact Sheets
Here are Fact Sheets on Managed Long Term Care, written by Medicaid Matters NY, a coalition of organizations that advocate for consumer rights in...
document Access to Health Care for People with Disabilities
People with disabilities may confront additional barriers to accessing health care. Barriers to enrolling in public health care programs like...
document Nursing Home Medicaid Coverage - Basic Financial Eligibility Rules about Income, Resources, and Spousal Protections
Medicaid rules are different for people living in the "community" than people living in institutions. For this article, the word "institution"...
document Transfer of Asset Rules in Medicaid -- The Deficit Reduction Act of 2005
On February 8, 2006, former President Bush signed into law the Deficit Reduction Act of 2005 (DRA). Among other things, this Federal law made major...
document NYS Directives on Medicaid changes under the Affordable Care Act
The New York State Department of Health (DOH) has issued additional directives outlining the new procedures for Medicaid applications and renewals...


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document Income and Resource Limits for New York State Public Health Insurance Programs
The Affordable Care Act changes the rules for Medicaid income eligibility for many BUT NOT ALL New Yorkers, expanding eligibility for many people...
document Medicaid Personal Care or Home Attendant Services
The Medicaid program in New York State covers a type of home care services called Personal Care Assistance (aka PCA or "home attendant"). To obtain...
document Medicaid Certified Home Health Agency (CHHA) Services
A Certified Home Health Agency (CHHA) provides what is commonly known as “visiting nurse” services, as well as physical or occupational or...
document Medicaid Spend-Down
Because Medicaid is a health insurance program for the poor, one must have income and assets below a certain limit to be eligible. For a single...
document Managed Long Term Care
Managed Long Term Care (MLTC) plans are insurance plans that are paid a monthly premium ("capitation") by the New York Medicaid program to approve...



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