A notice will be mailed the week of August 8, 2005 to clients statewide advising them of new co-payment requirements and changes to vision coverage. This notice will also include a warning regarding the discontinuance of Family Health Plus (FHP) for government employees, as they are no longer eligible to obtain FHP, in accordance with a change in Social Services Law ยง 369-ee(2)(a)(iii). Effective September 1, 2005, clients enrolled in FHP will be required to make co-payments for certain health/medical services, including pharmacy co-payments similar to those incurred by Medicaid recipients.
Requests regarding the FHP co-pay requirements should be coded similarly to previous managed care co-payment issues and are likewise NOT subject to Aid Continuing.
Although the change in the law itself is not a hearable issue, if a client feels s/he is wrongfully being required to make co-payments, s/he may request a fair hearing and a determination will be made by the Administrative Law Judge (ALJ) as to whether the issue is hearable. Reasons that exempt a recipient from having to pay the co-payment are listed in the letter.
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