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EFLRP Submits Comments on Medicare and Medicaid Regulation Proposals

Rebecca Wallach, Director of NYLAG’s Evelyn Frank Legal Resources Program (EFLRP), and Valerie Bogart, Of Counsel, recently submitted two sets of comments on proposed federal regulations that affect access to both Medicare and Medicaid for older people and people with disabilities.

In one set of comments, EFLRP supported changes that the federal Medicare agency, Centers for Medicare & Medicaid Services (“CMS”), will make to improve Medicare Advantage “Special Needs Plans” that are targeted to people who have both Medicare and Medicaid, known as “dual eligibles.” EFLRP urges CMS to restrict how these “D-SNP” plans attract dual eligibles with Over-the-Counter cards and so-called “supplemental” benefits, while restricting access to Medicare providers and services. Our comments cited examples of New York consumers who have suffered because of misinformation about these plans. Read our comments on the D-SNP regulations here.

In other comments, EFLRP supported changes CMS proposed to make to improved access to Medicaid “Home and Community-Based Services,” including home care. EFLRP urged CMS to extend the changes to the Managed Long Term Care (“MLTC”) program, which is authorized under a “Section 1115” waiver. If our proposal is not adopted, the important access changes CMS proposed will apply only to “1915(c)” waivers. In New York State, these are the Traumatic Brain Injury waiver, Nursing Home Transition & Diversion Waiver, OPWDD waiver, and the Children’s Waiver. Not covering the MLTC program would deny crucial protections to over 300,000 New Yorkers. Read our comments on the HCBS Access Rule here.

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