EVELYN FRANK LEGAL RESOURCES PROGRAM
MANAGED LONG-TERM CARE: ISSUES IN 2016 APPENDIX A. Materials on Immediate Need Personal Care Services a. NYC HRA Medicaid Alert Oct. 19, 2016 ......................................................... 1 b. Attestation of Immediate Need Form – NYS OHIP 0103 .............................. 6 c. IMMEDIATE NEED TRANSMITTAL TO THE HOME CARE SERVICES PROGRAM...............................................................................................7 d. Spousal Budgeting Assessment Request Form (can also be used with MLTC after application ............................................................................................ 8 B. Materials on FIDA & MLTC & Hearings a. NYC HRA Form Notice to All MLTC Members about FIDA – 10/2016…. 9 b. MLTC and FIDA plan lists .............................................................................. 10 c. Form for requesting MLTC plan documens for Fair Hearing prep ............... 15 C. ICAN____________________________________________________________ 1. ICAN Brochure – Independent Consumer Advocacy Network – State
Sponsored Ombudsprogram for MLC and FIDA, and Mainstream Managed Care issues regarding long term care services ................................................. 17
Medical Insurance and Community Services Administration (MICSA)
MEDICAID ALERT Immediate Need for Personal Care or Consumer Directed Personal Assistance Services The purpose of this Alert is to inform Medicaid providers, community based organizations and others assisting Medicaid clients of the procedure for requesting Immediate Need Personal Care or Consumer Directed Personal Assistance Services. I.
Consumer with Immediate Need for Home Care Services
In order to be considered a consumer with an Immediate Need for Home Care Services, the consumer must meet the following conditions: a.
Have an immediate need for Personal Care or Consumer Directed Personal Assistance Services;
b.
Have no informal caregivers available, able or willing to provide personal care services;
c.
Have no home care agency providing needed assistance;
d.
Does not have third party insurance or Medicare benefits available to pay for needed assistance;
e.
Does not have adaptive or specialized equipment or supplies in use to meet, or has adaptive or specialized equipment or supplies that cannot meet, the person’s need for assistance.
A consumer must attest to meeting these conditions by completing and signing the OHIP-0103, Immediate Need for Personal Care Services/Consumer Directed Personal Care Services: Informational Notice and Attestation Form.
II.
Submission of an Immediate Needs Request
A new transmittal, HCSP-3052, Immediate Need Transmittal to the Home Care Services Program has been developed to facilitate Immediate Needs Requests. Required documents vary depending on whether or not the consumer is already in receipt of Medicaid with coverage for long term care, needs
NYC Medicaid Alerts are a Periodic Service of the NYC Human Resources Administration Medical Assistance Program • Office of Eligibility Information Services • 785 Atlantic Avenue, Brooklyn, NY 11238 Steven Banks, Commissioner Karen Lane, Executive Deputy Commissioner Maria Ortiz-Quezada, Director of EIS Copyright 2016 The City of New York, Department of Social Services. For permission to reproduce all or part of this material contact the New York City Human Resources Administration.
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NYC MEDICAID ALERT
to upgrade their Medicaid coverage to include long term care or needs to apply for Medicaid. These requirements are detailed on the transmittal. A. Documents to be Submitted All consumers: 1) Attestation of Immediate Need (OHIP- 0103); 2) Medical Request for Home Care (HCSP-M11q). If the M-11q is not readily available a physician’s order may be submitted for purposes of determining if the consumer has an immediate need for an expedited Medicaid eligibility determination. A M-11q is required to begin the expedited immediate need home care service assessment and determination; 3) Authorization for Release of Health Information Pursuant to HIPAA (OCA-960). This is needed to be able to discuss case with person(s) other than the client) 4) Optional (but strongly recommended) – A cover letter that includes an explanation of the immediate need, the status of consumer’s current whereabouts, a listing of submitted documents, the type of service requested (PCS or CDPAS), etc. Consumers with active Medicaid coverage that needs to be upgraded to include community based long term care, also must submit: 1) A completed Access NY Supplement A (DOH-4495A)* * Note: For purposes of the eligibility determination, a consumer who would otherwise be required to document his or her accumulated resources may attest to the current value of any real property and to the current dollar amount of any bank accounts. Consumers without active Medicaid also must submit: 1) A completed Access NY Insurance Application (DOH-4220) 2) A completed Access NY Supplement A (DOH 4495A)* * Note: For purposes of the eligibility determination, a consumer who would otherwise be required to document his or her accumulated resources may attest to the current value of any real property and to the current dollar amount of any bank accounts. Consumers with Medicaid coverage on the Health Exchange (NY State of Health): The consumer/representative must contact NY State of Health (855-355-5777 or via email (
[email protected]) to have the Medicaid transferred to HRA. For these consumers the OHIP-0103, Immediate Need for Personal Care Services/Consumer Directed Personal Care Services: Informational Notice and Attestation Form and the M-11Q, Medical Request for Home Care or physician’s order for personal care, must be sent to HRA.
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NYC MEDICAID ALERT
Where to Submit
1)
Mail to:
HRA HCSP – Attention: Immediate Needs Liaison 785 Atlantic Avenue, 7th Floor Brooklyn, New York 11238
2)
Deliver to: HRA HCSP – Attention: Immediate Needs Liaison 785 Atlantic Avenue, 7th Floor Brooklyn, New York 11238
3)
eFax to: 917-639-0665
III.
Processing of Immediate Needs Cases:
The Immediate Need Request packages are logged in and date stamped to establish date of receipt. The expedited processing begins the first calendar day after receipt of the documents. The first calendar day will be referred to as day one (1). Medicaid Determination 1. Within four (4) calendar days after day one (1), the HCSP Medicaid Eligibility Unit (MEU) will review the submitted documents for completeness to determine if a Medicaid eligibility review can proceed. a. If review of the Medicaid Application, Supplement A and supporting documents determines that the package is incomplete, a written notice will be sent to the applicant explaining that the Medicaid processing is deferred. The notice will state what information and/or supporting documents are missing. It will also provide a response due date. b. If the Medicaid Application and Supplement A are determined to be complete and all of the required supporting documents are submitted, a Medicaid determination will be made by the seventh day (7th) calendar day after day one (1). Service Authorization Review 1. On day one (1), the Medical Request for Home Care (M11-q) and cover letter, if applicable, will be scanned and registered in the Long Term Care Web (LTCW) system and reviewed for completeness, accuracy and compliance with NYSDOH regulations. 2. Concurrently, the process of scheduling a home visit will be initiated upon verification of a complete Medicaid Application or conversion request for Medicaid with coverage for Long Term Care.
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NYC MEDICAID ALERT
3. If the HCSP-M11q is found to be complete, accurate and compliant with regulations, a home visit with the applicant will be scheduled. The service authorization review will be completed prior to the twelfth (12th) day from day four. 4. If the HCSP-M11q is found to be incomplete, not accurate or non-compliant with regulations, it will be rejected. A written notice will be sent to the applicant / family / representative stating the reason for the HCSP M11q’s rejection. A new Immediate Need request can be submitted with a Attestation form and properly completed M11-q 5. If the applicant is approved for services, the case will be assigned by the 12th day from day four to a HRA contracted License Home Care Services Agency or Fiscal Intermediary as appropriate. 6. If the applicant is not approved for services, a written notice will be sent to the applicant / representative indicating the reason for denial of services. More information is available in the New York State Department of Health’s ADM: 16 OHIP/ADM-02 Immediate Need for Personal Care Service and Consumer Directed Personal Assistance Services.
Please note that in addition to posting the new transmittal (HCSP-3052) and OHIP -0103 forms on MARC, these forms have also been added to HRA’s internet site (Long Term Care) page (http://www1.nyc.gov/site/hra/help/long-term-care.page) to help ensure these forms are readily available. . PLEASE SHARE THIS ALERT WITH ALL APPROPRIATE STAFF
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IMMEDIATE NEED FOR PERSONAL CARE SERVICES/CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES: INFORMATIONAL NOTICE AND ATTESTATION FORM
If you think you have an immediate need for Personal Care Services (PCS) or Consumer Directed Personal Assistance Services (CDPAS), such as housekeeping, meal preparation, bathing, or toileting, your eligibility for these services may be processed more quickly if you meet the following conditions: • • • •
You have no informal caregivers available, able and willing to provide or continue to provide care; You are not receiving needed help from a home care services agency; You have no adaptive or specialized equipment or supplies in use to meet your needs; and You have no third party insurance or Medicare benefits available to pay for needed help.
If you don’t already have Medicaid coverage, and you meet the above conditions, you may ask to have your Medicaid application processed more quickly by sending in: a completed Access NY Health Insurance Application (DOH-4220); the Access NY Supplement A (DOH-4495A or DOH-5178A), if needed; a physician’s order for services; and a signed *“Attestation of Immediate Need.” If you already have Medicaid coverage that does not include coverage for community-based long term care services, you must send in a completed Access NY Supplement A (DOH-4495A or DOH5178A), a physician’s order for services and a signed *“Attestation of Immediate Need.” If you already have Medicaid coverage that includes coverage for community-based long term care services, you must send in a physician’s order for services and a signed *“Attestation of Immediate Need.” If you don’t already have Medicaid coverage or you have Medicaid coverage that does not include coverage for community-based long term care services: All of the required forms (see the appropriate list, above) must be sent in to your local social services office or, if you live in NYC, to the Human Resources Administration (HRA). As soon as possible after receiving all of these forms, the social services office/HRA will then check to make sure that you have sent in all the information necessary to determine your Medicaid eligibility. If more information is needed, they must send you a letter, by no later than four days after receiving these required forms, to request the missing information. This letter will tell you what documents or information you need to send in and the date by which you must send it. By no later than 7 days after the social service office/HRA receives the necessary information, they must let you know if you are eligible for Medicaid. By no later than 12 days after receiving all the necessary information, the social services office/HRA will also determine whether you could get PCS or CDPAS if you are found eligible for Medicaid. You cannot get this home care from Medicaid unless you are found eligible for Medicaid. If you are found eligible for Medicaid and PCS or CDPAS, the social services office/HRA will let you know and you will get the home care as quickly as possible. If you already have Medicaid coverage that includes coverage for community-based long term care services: The physician’s order and the signed Attestation of Immediate Need must be sent to your local social services office or HRA. By no later than 12 days after receiving these required forms, the social services office/HRA will determine whether you can get PCS or CDPAS. If you are found eligible for PCS or CDPAS, the social services official/HRA will let you know and you will get the home care as quickly as possible. The necessary forms may be obtained from your local department of social services or are available to be printed from the Department of Health’s website at: http://www.health.ny.gov/health_care/medicaid/#apply *Found on the back side of this page.
New York State Department of Health
OHIP‐0103
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Attestation of Immediate Need for Personal Care Services/Consumer Directed Personal Assistance Services
I,
attest that I am in need of immediate Personal Care Services (Name) or Consumer Directed Personal Assistance Services.
I also attest that: •
no voluntary informal caregivers are available, able and willing to provide or continue to provide needed assistance to me;
•
no home care services agency is providing needed assistance to me;
•
adaptive or specialized equipment or supplies including but not limited to bedside commodes, urinals, walkers or wheelchairs, are not in use to meet, or cannot meet, my need for assistance; and
•
third party insurance or Medicare benefits are not available to pay for needed assistance.
I certify that the information on this form is correct and complete to the best of my knowledge. X SIGNATURE OF APPLICANT/ REPRESENTATIVE
DATE SIGNED
Individuals Receiving Long Term Care Services in a Nursing Home or Hospital Setting If you are receiving long term care services in a nursing home or a hospital setting and intend to return home, you may have your eligibility for Personal Care Services or Consumer Directed Personal Assistance Services processed more quickly. Follow the directions on the previous page and fill in the information requested below. I am in a nursing home or a hospital setting and have a date set to return home on . DATE
Contact me or my legal representative by calling
New York State Department of Health
OHIP‐0103
.
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IMMEDIATE NEED TRANSMITTAL TO THE HOME CARE SERVICES PROGRAM HCSP-3052 (E) 09/19/2016
DATE: ________________________
CONSUMER’S NAME:_____________________________________ LAST 4 DIGITS OF CONSUMER’S SSN: ___________________
From
To:
NAME OF SUBMIITING ORGANIZATION
HOME CARE SERVICES PROGRAM – IMMEDIATE NEEDS STREET ADDRESS
785 ATLANTIC AVENUE, 7th Floor CITY, STATE, ZIP CODE
BROOKLYN, NY 11238 I am submitting this application package on behalf of the above named consumer for processing as an “Immediate Need” for home care services. S/he wishes to be enrolled in the following program (check one):
Personal Care (PCS)
Consumer Directed Personal Assistance (CDPAS)
I understand that the documentation listed in the table(s) below is required for this request to be processed. All are attached and appear to be fully completed. For all Immediate Need Requests OHIP-0103, Attestation of Immediate Need
HCSP M-11q, Medical Request for Home Care
OCA-960, Authorization for Release of Health Information Pursuant to HIPAA
Also required, in addition to the three items listed above, if the consumer already has Medicaid coverage, but it does not include long term care coverage All necessary proofs that apply to this supplemental form only, as detailed in the DOH-4220 “Documents Needed When You Apply For Public Health Insurance” section
DOH-4495A, Access NY Supplement A
Also, required in addition to everything listed in both tables above, if the consumer does not already have Medicaid coverage at all All necessary proofs as detailed in the DOH-4220 “Documents Needed When You Apply For Public Health Insurance” section
DOH-4220, Access NY Insurance Application
Though not required, I understand that submission of a cover letter that includes an explanation of the immediate need, the status of consumer’s current whereabouts, a listing of submitted documents, the type of service requested (PCS or CDPAS), is strongly recommended.
I have attached a cover letter
Print Name:
I have not submitted a cover letter Sign Name:
Telephone Number:
-7-
Date:
Request for Assessment Form Institutionalized Spouse’s Name:
Address:
Telephone Number: Community Spouse’s Name:
Current Address:
Telephone Number:
I/we request an assessment of the items checked below: [ ]
Couple’s countable resources and the community spouse resource allowance
[ ]
Community spouse monthly income allowance
[ ]
Family member allowance(s)
Check [ ] if you are a representative acting on behalf of either spouse. Please call your local department of social services if we do not contact you within 10 days of this request.
______________________________________________ Signature of Requesting Individual Address and telephone # if different from above ______________________________________________
NOTE: If an assessment is requested without a Medicaid application, the local department of social services may charge up to $25 for the cost of preparing and copying the assessment and documentation.
March 2014 New York State Medicaid Update
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______________________________________________ ______________________________________________
9|P a g e
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New York City Plan List New York City
MLTC Medicaid Plans What services will these Plans provide? nM edicaid home care and other long term care services, including:
personal care (home attendants), home health aides, adult day health care, consumer directed personal assistance services, dental care, transportation, and other services. nN o Medicare services. nW hat else should I know? You can keep seeing your Medicare or Medicare Advantage doctor and other providers of services not covered by the Plan. MLTC Medicaid Plans Service Area
Aetna Better Health
1-855-456-9126 Brooklyn, TTY: 711 Queens, www.aetnabetterhealth.com Manhattan
AgeWell New York
1-866-586-8044 TTY: 1-800-662-1220 www.agewellnewyork.com
Bronx, Brooklyn, Queens, Manhattan
AlphaCare of New York, Inc.
1-888-770-7811 TTY: 711 www.alphacare.com
Bronx, Brooklyn, Queens, Manhattan
ArchCare Community Life
1-855-467-9351 TTY: 711 www.archcare.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Centerlight Healthcare Select MLTC
1-877-226-8500 TTY: 1-800-650-2774 www.centerlight.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Centers Plan for Healthy Living
1-855-270-1600 TTY: 1-800-421-1220 www.centersplan.com
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Empire BlueCross BlueShield HealthPlus
1-866-805-4589 TTY 1-800-855-2880 www.empireblue.com/ medicaidmedicare
Bronx, Brooklyn, Queens, Manhattan, Staten Island
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MLTC-MED-PL-E-1115
Contact
Contact
Service Area
Extended MLTC
1-855-299-6492 TTY: 711 www.extendedmltc.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Fidelis Care at Home
1-800-688-7422 TTY: 1-800-695-8544 www.fideliscare.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
GuildNet
1-800-932-4703 TTY: 1-800-662-1220 www.guildnetny.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
HomeFirst, a product of Elderplan
1-866-389-2656 TTY: 1-800-662-1220 www.homefirst.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Independence Care System
1-877-427-2525 TTY: 711 www.icsny.org
Bronx, Brooklyn, Queens, Manhattan
Integra MLTC, Inc.
1-855-661-0002 TTY: 711 www.integraplan.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
MetroPlus Managed Long Term Care
1-855-355-6582 TTY: 1-800-881-2812 www.metroplus.org
Bronx, Brooklyn, Queens, Manhattan
Montefiore Diamond Care
1-855-556-6683 TTY: 711 www.montefiore.org/ healthplans-medicaid
Bronx
North Shore-LIJ Health Plan, Inc.
1-855-421-3066 TTY: 1-855-871-1665 www.nslijhealthplans.com
Brooklyn, Queens, Manhattan, Staten Island
RiverSpring at Home
1-800-370-3600 TTY: 1-866-236-5800 www.riverspringathome.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Senior Health Partners A Healthfirst Company
1-866-585-9280 TTY: 1-800-662-1220 www.shpny.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
Questions?
1-888-401-MLTC or 1-888-401-6582 (TTY: 1- 888-329-1541)
New York Medicaid Choice
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MLTC-MED-PL-E1115
MLTC Medicaid Plans
MLTC Medicaid Plans Contact
Service Area
Bronx, Brooklyn, 1-877-353-0185 Queens, TTY: 711 www.seniorwholehealth.com Manhattan
UnitedHealthcare Personal Assist
Bronx, Brooklyn, 1-855-345-6582 Queens, Manhattan, TTY: 711 www.uhccommunityplan.com Staten Island
VillageCareMAX
1-800-469-6292 TTY: 1-800-662-1220 www.villagecaremax.org
Bronx, Brooklyn, Queens, Manhattan
VNSNY CHOICE Managed Long Term Care
1-888-867-6555 TTY: 711 www.vnsnychoice.org
Bronx, Brooklyn, Queens, Manhattan, Staten Island
WellCare Advocate MLTC
1-866-661-1232 TTY: 1-877-247-6272 www.newyork.wellcare.com
Bronx, Brooklyn, Queens, Manhattan, Staten Island
MLTC-MED-PL-E-1115
Senior Whole Health of New York MLTC
Questions?
1-888-401-MLTC or 1-888-401-6582 (TTY: 1- 888-329-1541)
New York Medicaid Choice
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FIDA Fully Integrated Duals Advantage New York City Plan List What is the FIDA Program? FIDA is a new program that gives you all your Medicare and Medicaid benefits – like doctor and hospital visits, medicines, home care, behavioral health care, and nursing home care in one managed care plan. No more multiple plan ID cards! To get your benefits with FIDA, you will use one member ID card. In addition, you will have other benefits like your care team who will work for you to make sure you get your services, get to your appointments, and get your medicine. You will not have to pay anything to your FIDA plan – no plan premiums, no deductibles, and no copayments. FIDA plans are managed care plans in the FIDA program. When you join a FIDA plan you are also part of the FIDA program. The FIDA Program is a partnership of New York State Medicaid and the Medicare Program. You may call all the FIDA plans below from 8:00 am to 8:00 pm, seven days a week.
Contact
Service Area
Aetna Better Health FIDA 1-855-494-9945 Brooklyn, TTY: 711 Manhattan, Queens aetnabetterhealth.com/ny AgeWell New York FIDA 1-866-586-8044 Brooklyn, Bronx, TTY: 1-800-662-1220 Manhattan, Queens agewellnewyork.com Centers Plan for FIDA Care Complete
1-800-466-2745 TTY: 1-800-421-1220 centersplan.com/fida/participants
Bronx, Brooklyn, Manhattan, Queens, Staten Island
Elderplan FIDA Total Care
1-855-462-3167 TTY: 711 elderplanfida.org
Bronx, Brooklyn, Manhattan, Queens, Staten Island
Fidelis Care FIDA Plan
1-800-247-1447 TTY: 1-800-695-8544 fideliscare.org
Bronx, Brooklyn, Manhattan, Queens, Staten Island
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PAGE 1
FIDA Plans – New York City
Contact
Service Area
GuildNet Gold Plus FIDA
1-800-815-0000 TTY: 1-800-662-1220 guildnetny.org
Bronx, Brooklyn, Manhattan, Queens, Staten Island
Healthfirst AbsoluteCare FIDA
1-855-675-7630 TTY: 711 healthfirst.org/mmp
Bronx, Brooklyn, Manhattan, Queens, Staten Island
ICS Community Care Plus 1-877-427-2525 FIDA MMP TTY: 711 (Independence Care System) icsny.org/care-plus
Bronx, Brooklyn, Manhattan, Queens
MetroPlus FIDA Plan 1-844-288-3432 TTY: 711 metroplus.org/fida
Bronx, Brooklyn, Manhattan, Queens
North Shore-LIJ FIDA 1-855-776-7545 Brooklyn, Live Well TTY: 711 Manhattan, Queens, NSLIJHealthPlans.com/FIDALiveWell Staten Island 1-800-950-9000 TTY: 1-866-236-5800 riverspringfida.org
Senior Whole Health FIDA 1-844-861-3432 TTY: 711 seniorwholehealth.com/FIDA
Bronx, Brooklyn, Manhattan, Queens, Staten Island Bronx, Brooklyn, Manhattan, Queens
VillageCareMAX Full Advantage FIDA Plan
1-800-469-6292 TTY: 711 villagecaremax.org
Bronx, Brooklyn, Manhattan, Queens
VNSNY Choice FIDA Complete
1-866-783-1444 TTY: 711 vnsnychoice.org
Bronx, Brooklyn, Manhattan, Queens, Staten Island
QUESTIONS? 1-855-600-3432 TTY: 1-888-329-1541
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PAGE 2
FIDA Plan List-NYC-E-0916
RiverSpring FIDA Plan (affiliated with ElderServe Health, Inc.)
Request For Fair Hearing Evidence Packet and Specifically Identified Documents Date: _______________________ MEMBER NAME _________________ Fair Hearing Number: ___________ Case Number Address:
DOB ___________________
__________________________________________________
To: Address:
[PLAN] - Fair Hearing Liaison ___________________________________________________________
Fax #:
___________ Tele: _________________
PLEASE SEND, FAX, or E-MAIL DOCUMENTS TO: NAME _____________ ___ADDRESS: _______________________ ATTN: _______________________________________________ E-MAIL ________________ FAX ___________________________ Pursuant to New York State regulationsi, please mail, e-mail or fax to the person listed above, within five days of this request: (a) copies of all documents the Plan will present at above fair hearing, and (b) copies of the documents listed in (c) below for the period from: _______
Member’s initial enrollment with the plan to present date, OR
_______
From DATE _______________ through the present date,
(c) ______ 1. all documents related to assessment for and authorization of personal care, home health aide/CHHA services, CDPAP, PERS, adult day health care, and any other long-term care services, including all SAAM or Uniform Assessments, nursing assessments, case management records, authorizations, plans of care, and Notices. ______ 2. All records of the licensed home care agency(ies) that have provided member’s home care; ________ 3. All signed enrollment forms and disenrollment forms or other documents pertaining to enrollment or disenrollment; ________ 4. All correspondence or records of phone calls, faxes or e-mails with member’s doctors, the home care agency providing services, the State Dept. of Health, or with any other person regarding member’s services, or eligibility, or need for services. ________ 5. If member received services from HRA CASA Home Care Services
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Program (personal care or CDPAP), a certified home health agency, a Lombardi Program, or any other home care program, any documents received from that program or pertaining to the last authorization of services from that program. THANK YOU. [Name], [Title] ORGANIZATION ADDRESS New York, NY ZIP TEL: FAX: E-MAIL: [e-mail]
i
18 N.Y.C.R.R. § 358-3.7(b)(1), (2); 18 N.Y.C.R.R. § 358-4.3(b)
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Our Services Are Free
What do we do? Toll-Free Helpline Anyone can call our toll-free telephone number to reach a live, expert health counselor. You can get accurate, in-depth guidance on your first call.
One-on-One Assistance Through our helpline or our network of agencies, we provide direct assistance to hundreds of people each month. Our cases range from quick advice calls to formal appeals.
Community Presentations
Get help today. Call: (844) 614-8800 Our helpline is open Monday through Friday, 8am to 8pm.
If you are hearing or speech impaired, you can use the NY Relay service by dialing 711
Get help with Managed Long Term Care
Email:
[email protected] Website: icannys.org ICAN is a program of the Community
Service Society, and is funded by the
State of New York.
We educate consumers, advocates and health care providers about Managed Long Term Care and FIDA.
633 Third Ave New York, NY 10017 (212) 254-8900 cssny.org
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ICAN Brochure, 8/2015
ICAN is an independent, free, and confidential resource to help you make the health insurance decisions that are right for you.
What is ICAN? ICAN is the New York State Ombudsprogram for people with Medicaid who need long term care services. We assist New Yorkers with enrolling in and using managed care plans that cover long term care services, such as home attendant services or nursing home care. We can help you by: Answering questions about Medicaid, Medicare, long term care, and managed care plans
ICAN is a statewide network of organizations
We help anyone in a Medicaid managed care plan who needs long term care services (like a home attendant or nursing home).
9 7 5 4
8
Who Does ICAN Help?
6 10 3 1
2
1. CSS Center for Independence of the Disabled, NY The Legal Aid Society Medicare Rights Center NY Legal Assistance Group 2. Nassau/Suffolk Law Services Comm.
Giving you information about your health insurance options, like the new FIDA program, and helping you decide what is right for you
3. Westchester Disabled On the Move
Solving problems with your managed care plan or providers, using negotiation or formal appeal processes
7. ACR Health
4. Legal Assistance of Western NY
We also help people who are applying for Medicaid and need help enrolling in a Managed Long Term Care (MLTC), Medicaid Managed Care (MMC), or Fully Integrated Duals Advantage (FIDA) plan. We can talk with you, your family member, or anyone who is helping you with your health insurance or care decisions.
5. Neighborhood Legal Services 6. Empire Justice Center 8. Action for Older Persons 9. Southern Adirondack Independent Living Center 10. Legal Services of the Hudson -18Valley
Call ICAN at
(844) 614-8800 or
visit icannys.org
