Managed Care

Advocates urge delay and slow roll-out of NYIAP expansion

The NYS Department of Health has announced an expansion of the NY Independent Assessor Program (NYIAP) to include reassessments beginning January 1, 2024. The planned expansion is too soon and the timeline for rolling it out is too aggressive to provide enough assurance people will not lose access to services they need. Advocates have raised concerns and made suggestions for consumer protections since the NYIAP was implemented, including in a letter to the Department of Health alongside the...

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2023 Medicaid Managed Care Priorities

The Medicaid Matters Managed Care Workgroup has published its priorities for 2023. Download the document here. These priorities are meant to accompany the coalition's overall 2023 Health Justice Agenda. Repeal Medicaid Redesign Team II Home Care Restrictions and “Lookback” enacted in 2020:Repeal the restrictive minimum of three Activities of Daily Living required for eligibility for Medicaid personal care and consumer-directed services.  These ADL thresholds discriminate because...

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Joint letter on the New York Independent Assessor

Consumer advocacy coalitions Medicaid Matters New York and the Coalition to Protect the Rights of New York's Dual Eligibles joined with representatives of Managed Long Term Care plans to send a joint letter to the Hochul administration to air concerns about the implementation of the New York Independent Assessor. Find the joint letter here.

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Consumer advocates issue statement on OSC MLTC report

Medicaid Matters joined nineteen other advocacy groups to issue a statement on the August 2022 report by the Office of the State Comptroller regarding New York's Medicaid Managed Long Term Care program, titled "Medicaid Program - Oversight of Managed Long-Term Care Member Eligibility." The statement's introduction describes the consumer advocacy perspective on the OSC's findings: Over 300,000 New Yorkers who have disabilities rely on Medicaid community-based long-term care services to live...

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Medicaid Matters on managed care procurement proposal

Governor Hochul's Executive budget for 2022-23 included a proposal to require managed care plans to go through a state procurement process in order to administer Medicaid in New York. Medicaid Matters issued a statement on the proposal to advance the interests of consumers in any discussion focused on changes to Medicaid Managed Care.

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Managed care focus of Assembly hearing on Medicaid

The Assembly Committee on Health held a hearing on November 1, 2021 entitled "Medicaid Program Efficacy and Sustainability." Medicaid Managed Care was a key focus of the hearing. Read more about the hearing in the Committee's hearing notice. Find Medicaid Matters' testimony here.

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New York’s potential transition to managed care for people with I/DD

For a number of years, the NYS Office for People with Developmental Disabilities (OPWDD) has explored the possibility of moving everyone with intellectual/developmental disabilities (I/DD) to mandatory enrollment in Medicaid Managed Care.  This was accelerated with Care Management for All, an initiative that came out of the original Medicaid Redesign Team in 2011, aimed at moving all Medicaid benefits and all people served by Medicaid into some form of care management.  Many people...

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Focus groups with individuals with I/DD and parents to inform our work

As part of the work with the Managed Care Community of Practice, Medicaid Matters conducted focus groups in June regarding information and outreach related to the State’s transition to Medicaid Managed Care for people with intellectual/developmental disabilities (I/DD).  The focus groups with individuals and parents (which were done separately) in New York City and Binghamton were intended to help inform our work on stakeholder engagement, education and outreach related to the transition...

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Education and outreach for individuals with developmental disabilities and their families

New York State is implementing a system of Medicaid Managed Care for people with intellectual and developmental disabilities (I/DD).  The New York Alliance for Inclusion and Innovation is currently undertaking a project to prepare providers of services to people with I/DD for the move to managed care.  Referred to as the Managed Care Community of Practice (MC-COP), the project aims to provide readiness training and technical assistance to any interested provider...

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MLTC Report

Mis-Managed Care: Fair Hearing Decisions on Medicaid Home Care Reductions by Managed Long Term Care Plans, June-December 2015 With the New York Chapter of the National Academy of Elder Law Attorneys, MMNY issued a report to shed light on the findings of an extensive study of fair hearing decisions on reductions of personal care and Consumer Directed Personal Assistance services hours by Managed Long Term Care (MLTC) plans.  The report makes specific policy recommendations to address the...

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