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Medicaid Alerts & Other Protocols published by the NYC HRA Medicaid Program

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Posted: 16 Oct, 2010
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Updated: 06 Feb, 2024
by Rachel Holtzman (New York Legal Assistance Group)

HRA Medicaid Alerts are periodic announcements of policy, staff and office changes published by the HRA Medicaid Progarm (formerly called the "Medical Insurance and Community Services Administration (MICSA)". The Medicaid Program   is the part of New York City’s Human Resource Administration (HRA) that administers Medicaid and the Medicare Savings Programs.   The Home Care Services Program (HCSP) in HRA administers Medicaid for people enrolled in MLTC plans or who receive personal care or CDPAP services from HRA.     

 When policy changes occur within MICSA’s programs considered important enough to be of concern to Home Care Providers, Home Health agencies, hospitals, and other community based organizations, MICSA sends out an announcement of the changes  known as a Medicaid Alert.  These announcements are sent out to community based organizations periodically throughout the year. 
Medicaid Alerts may be useful by advocates in verifying policy changes to frontline Medicaid workers.    We have compiled ones that are pertinent as of November 2010.   They are organized in 3 general categories:  
  • Medicaid Eligibility & Procedures - include applications, renewals, verification of citizenship/immigration status, etc.
  • Medicaid Home Care
  • Medicaid/CASA Office Relocations & Staff
Within each category, they are listed chronologically with a KEY TOPIC for ease in finding pertinent directives.
Please email us to provide any other HRA Medicaid directives that might be helpful to others.   


DATE             TOPIC                                   TITLE


2024-01-23 Submission of the DOH-4220 Application's Appropriate Pages

There are different version of the statewide DOH-4220 Medicaid Application form, which applicants use to apply for non-MAGI Medicaid. The Medical Assistance Program (MAP) accepts the DOH-4220 form versions dated: 1/23, 8/21, and 3/15. However, if an applicant is using one of the two older version of the DOH-4220 form (dated 8/21 or 3/15), the applicant must also submit the OHIP-0112 and DOH-5130. Meanwhile, it is important that Medicaid providers use only one version of the form per applicant; it is not permitted for providers to submit an application for an applicant that contains pages from different version of the DOH-4220.


2023-12-28 Contact Information Update for the Medical Assistance Program's Third-Party Health Insurance Unit

The Medical Assistance Program's (MAP) Third-Party Health Insurance (TPHI) Unit's contact information has been updated. Now, the TPHI Unit can be reached by eFax at (917) 639-0675 or by email at maptphi@hra.nyc.gov . As a reminder, the TPHI Unit assists with requests for verification of third-party health insurance, and removing/updating of a third-party health insurance policy to an individual's Medicaid case. Meanwhile, if you have questions about commercial health insurance premiums and reimbursements, contact hipp@hra.nyc.gov .

2023-06-30 Unwinding of the Medicaid Continuous Coverage Requirement 

COVID easements pertaining to Medicaid ended March 31, 2023 and as such:

  • Consumers with unresolved immigration or citizenship will be expected to document at their renewal.
  • Disenrollment from Mainstream Managed Care will resume for clients in receipt of Medicare.
  • Health Insurance Premium Payments (HIPP) and Medicare Insurance Premium Payment (MIPP) program payments will be updated should past payments need any adjustments. Overpayments made during the Public Health Emergency will not be recovered.
  • MBI-WPD individuals must submit proof of work but may attest to the amount of their income and resources at renewal.
  • Current Medicaid consumers who do not contact HRA for a recalculation of their income in response to the December 2022 one-time letter, will have their eligibility redetermined at the next consumer contact or at renewal, whichever comes first.
  • For Spenddown cases, districts will not seek retroactive recoupment of pay-in payments.
  • After 6/30/23, applicants and recipients for nursing home care is no longer permitted to self-attest to income, resources, and asset transfers during the look-back period.
  • Effective 7/1/23, consumers can no longer submit an attestation of filings or of intent to file a petition for guardianship.
  • There are special protections for returned Renewal packets. 
  • Effective 7/1/23, application and requests for increase in coverage received on or after that date are to be processed in accordance with regular Medicaid rules.
  • Cases resulting from closed and rejected Cash Assistance cases or closed SSI cases will continue to be extended through the end of the PHE.
  • HRA will no longer accept MAP-3044 that list COVID-19 as the reason for incapacity.

2023-05-31  NY Independent Assessor & Changes to Personal Care (PCS) Assessment Process

Explains what consumers seeking Medicaid CDPAP or personal care (PCS) should do in 2 situations: (1) Those who contacted NYIA directly, rather than applying for Immediate Need services and who are not in a Mainstream Medicaid managed care plan (known as "Fee for service (FFS) consumers") - If the NYIA notice says they are not eligible to enroll in MLTC and refers them to the LDSS - they should fax a copy of their NYIA decision notice to the CASA Central Intake unit (718) 636-7784. Case will be assigned to a CASA to use the notice to retrieve the NYIA assessments and then proceed to assess whether eligible for PCS or CDPAP. But.. if they are a dual eligible and not in a hospice program, or in OPWDD, TBI or NHTD waiver - they are probably only eligible for 8 hours/WEEK of Housekeeping services from CASA. 

(2) If you applied to HRA for Immediate Need services - PCS or CDPAP via eFax (917) 639-0665 - you should not have to contact the HRA Home Care Services Program/CASA after the NYIA assessments -- because NYIA should notify CASA of the outcome of the assessments directly and they should contact you about next steps to decide if you are eligible for services and if so - what is your plan of care.

2023-04-07 ACCESS HRA Client Portal Enhancements – As of 4/4/23, Medicaid-only consumers will be able to submit their Medicaid renewal online using ACCESS HRA as an alternative to returning the paper forms. Medicaid-only cases with authorization ending 6/30/23 or later, can alternatively submit their renewal on ACCESS HRA. (Read more about Medicaid Renewals here.)

  • Consumers that are Disabled Aged and Blind (DAB) or non-MAGI, including those in the Medicaid Excess Income or Surplus program and those that receive homecare services through a Managed Long Term Care (MLTC) plan) can now use ACCESS HRA to submit their renewal by logging in or creating an account at www.nyc.gov/accesshra.
  • All active Medicaid-only cases with authorization end dates 3/31/20 through 5/31/23, will continue to be systemically extended for 12 months and individuals will not be required to renew their Medicaid eligibility during the emergency period.
  • Consumers can view their Medicaid case information including: Recert Due Date (currently named Eligibility End Date), Surplus coverage status and Surplus amount.  The “Make a Payment” button in the right navigation links to CityPay portal which allows Surplus clients to pay their Surplus.  However, consumers that have never submitted a payment through the Division of Accounts Receivable & Billing (DARB), must contact DARB to be registered prior to submitting an online payment at 718-557-1399.

2023-03-31 Transition of the Pharmacy benefit from Managed Care to NYRx, the Medicaid Pharmacy Program

  • As of 4/1/23, individuals in Mainstream Managed Care (MMC), Health and Recovery (HARP), and HIV Special Needs (SNP) plans will get their Pharmacy Benefits through the New York Medicaid Pharmacy Program (NYRx; formerly Medicaid Fee-For Service Pharmacy Program) and will receive notification of the change by mail. This does not apply to members enrolled in Managed Long-Term Care (MLTC), the Essential Plan, and Child Health Plus (CHP).
  • Nearly all drugs currently covered by MMC plans will continue to be covered by NYRx. However, some drugs under Medicaid fee for services may require NYS prior authorization. Drug co-payments will not change.
  • Consumers must present their Medicaid Common Benefit Identification Card (CBIC), which has their client identification number (CIN) and not their the MMC card or plan card.
  • Members who are in the Restricted Recipient Program (RRP) prior to 4/1/23 will remain restricted for other services when the prescription drug benefit transitions to NYRx.
  • Information is available by calling NYRx Medicaid Helpline at 1-855-648-1909 (1-800-662-1220 TTY), Monday – Friday, 8AM - 8PM and Saturday 9AM - 1PM.  Read more here.

2023-01-25 Medicaid Program Modifications COVID-19 Emergency updates the alerts issued 3/27/20, 6/22/20, 8/10/20, 9/9/20, 12/17/20, 1/13/21, 2/22/21, 3/25/21, 4/27/21, 5/21/21, 6/14/21, 8/4/21, 8/23/21,11/5/21, 12/6/21, 1/24/22, 3/14/22, 4/14/22, 5/9/22, 7/5/22, 9/8/22, 10/25/22 & 12/08/22.

The Consolidated Appropriations Act of 2023 (which was signed into law in December 2022) de-links the Medicaid continuous coverage requirement from the Covid Public Health Emergency. 

COVID easements pertaining to Medicaid applications and renewals are ENDING.

  • New applications: Currently, clients may attest to all elements of eligibility except immigration status and identity. However, effective July 1, 2023, full eligibility documentation will be required.   
  • Medicaid cases with authorization end dates through May 31, 2023 will not be closed for failure to renew and will be extended.  Clients with Medicaid cases that are authorized ending in June 2023 will be mailed renewals in March or beginning of April 2023.  These clients (and those with authorized end dates after June 2023) must return their renewals and provide relevant documentation with updated income.  The 2023 Medicaid allowable income levels will be applied.  If the renewal is not completed and returned the case may close.


2022-12-22  Increase in Medically Needy Income and Asset Levels in 2023 and Sample Form MAP-3190 2023 Budget Review Request Form - With 2023 Income levels increasing to 138% Federal Poverty Level (see  GIS 22 MA/11)  announces new NYC MAP-3190 form that will be sent in January to all NYC recipients who have a spend-down.   Recipients may complete and return to request a budget review to decrease their spend-down.  This NYC letter follows  the similar State DOH notices also sent to spend-down and MSP recipients statewide. See more here.    HRA asks consumers to use the enclosed bar-coded form that they will receive by mail to ensure faster processing. 

2022-10-18 Reopening of Approved Client Representative Window - Effective 9/29/22, the Authorized Client Rep (C-Rep) Window 1 at  HRA, 785 Atlantic Ave., Brooklyn, NY 11238 has resumed business for bulk application submissions and for use by Approved Client Reps. or agencies only.

2022-08-12 NYC Medicaid Alert: Relocation of the Coney Island Medicaid Office - Effective 8/15/22, the office will be relocated to: 1912 Mermaid Avenue, 2nd Flr., Brooklyn, NY 11224.

2022-06-30- POOLED TRUSTS & DISABILITY DETERMINATIONS  + MBI-WPD  --revises alert issued 5/31/22
Disability Determination by NYS Disability Review Team (DRT) - Change in Forms Required for submissions to HRA for Pooled Trusts or MBI-WPD for people who need a disability termination - effective June 1, 2022  (DISABILITY DETERMINATION REQUEST (MAP-3177) is posted on NYC HRA Health Assistance webpage  in many languages:

2022-05-13 New York Independent Assessor (NYIA) - Beginning May 16, 2022, any adult 18 and older seeking fee for service (FFS) Personal Care Services (PCS) and/or Consumer Directed Personal Care Services (CDPAS) for the first time or seeking initial MLTC plan eligibility must be referred to NYIA for their Community Health Assessment (CHA) and Clinical Appointment (CA). This change does not include the Immediate Needs process at this time.  NYIA will conduct independent assessments, provide independent practitioner orders, and perform independent reviews of high needs cases for PCS and CDPAS. The NYIA will also take over the work currently done by the Conflict Free Evaluation and Enrollment Center (CFEEC) to assess individuals for MLTC plan eligibility.  See more news here re NYIA.

2022-03-24 Revised DOH-4220, Access NY Health Care Application – The statewide DOH-4220 Medicaid Application form used to apply for non-MAGI Medicaid has been updated (dated 8/2021 but HRA just announced this change in this alert).  If an applicant submits an older version of the form, the agency will continue to accept it and not require the applicant to complete the newer application form.  However, copies of the OHIP-0112 and DOH-5130 would need to be sent with the older application.  Reminder that as of March 1, 2022, the DOH-5178A  will be the only Supplement A accepted with the DOH-4220 application.

2022-02-04 Changes to the LDSS-3183 Provider or MLTC Plan and Recipient Letter – A Medicaid Recipient who submits medical bills from a Provider to meet the spenddown will receive an OHIP-3183 “Provider/Recipient Letter” indicating which medical expenses are the responsibility of the Recipient (and which the Provider should not bill to Medicaid). When the Recipient is enrolled with a Managed Long Term Care Plan (MLTC), the Recipient and the MLTC will receive an OHIP-0128 “MLTC/Recipient Letter” indicating the amount that the Recipient owes to the MLTC (after deducting the medical expenses/bills from the spenddown).  These forms replace the LDSS-3183 form.


2021-12-28 Usage of DOH 5178A Medicaid Application Supplement and DOH 4495A – The subject of this Medicaid alert was included (albeit buried) in an earlier alert, 2020-12-22 Asset Verification System Expanded to all DAB/SSI Related Submissions

New Medicaid Applications in NYC must be accompanied by DOH 5178A Supplement A form, even if the applicant is attesting the amount of their resources.  The old form (DOH 4495A) will be accepted provided it is accompanied by DOH 5148 or DOH 5149.  As of March 1, 2022, only the DOH-5178A will be accepted.   See this article for more about using the new Supplement A form.

2021-12-20  POOLED TRUSTS & DISABILITY DETERMINATIONS  - Form 486T Replaced by DOH-5143 form

Medical Report for Determination of Disability -- Form 486T Replaced by DOH-5143 form.  Announces a change in the form for the treating physician to certify disability as needed to approve supplemental needs trusts including pooled trusts, and Medicaid based on disability, if disability has not been  certified by the SSA. Replaces  Form 486T will be accepted until Feb. 1, 2022. New form available here (fillable). 

2021-12-16 Medical Assistance Program Request for Information form MAP-751vHRA is requesting consumers to update their residential or mailing address (as well as alternative format and language preferences).  The alert refers to Form 751k (fillable) for recipients to report a change of address (or such other preferences). Download 751k in various languages here.  (This is to ensure when the Public Health Emergency is declared over and HRA (and other local Medicaid agencies) sends renewal packages that must be returned, the same are sent to the proper address.)  

2021-10-29 Medicaid Surplus Coverage Update – During the Covid Health Emergency, surplus consumers must continue to meet their surplus requirement and, upon payment, should contact the Surplus Hotline to report that a payment was made. If consumers cannot make a surplus payment or their income have gone down, they should have their case re-budgeted.  If they are unable to submit payment because of health issues related to Covid-19, such as quarantine or hospitalization, they can attest by calling the Surplus Hotline.

2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers - provides instructions for Online Credit Card payment to the Division of Accounts Receivable and Billing (DARB) to participate in the Medicaid Pay-In Program.  Use this link to NYC CityPay website.  Medical bills cannot be submitted through this website.

2021-09-27  NYC Medicaid Alert: Transitioning of MAGI-Like Medicaid Cases from DSS/HRA Medicaid to NY State of Health Exchange

Since the New York State of Health was introduced in 2014, it has been responsible for all MAGI Medicaid cases. However, there were many Medicaid consumers with MAGI-like budgeting who were found eligible before January 1st, 2014. Their cases have remained with HRA until they could be transitioned. Those consumers were to be transitioned in phases and the first transition began in June 2018. NYS has resumed the transition and approx. 158,600 individuals transitioned between April 2021 through July 2021. The alert details which groups of MAGI recipients were transitioned and those who will not be transitioned. Clients will not be required to renew their coverage in NYSOH until after the COVID-19 Health Emergency ends.

2021-09-22 Reopening of Chinatown Medicaid Office

Chinatown Medicaid Office reopened at the same location (115 Chrystie St., 5th Fl., New York, NY 10002; tel. (212) 334-6114).  Open 9:00am to 5:00pm, Monday thru Friday.

2021-09-08 MAP Undercare Division Email Address -  revises previous July21, 2021  alert to clarify that reporting changes with the new MAP-751K forms and requesting budgeting changes with the 751w form may be submitted either by email  to undercareproviderrelations@hra.nyc.govor by fax to 917-639-0837.  These forms are attached to the Alert and are available for download in various languages at HRA site here,   you can download fill-in-able MAP-751k (3/15/21) and MAP-751W  (3/25/21) in English. 

2021-08-12  HRA MICSA Alert 8-12-2021 Disability Determination Form LDSS-1151 Replaced with DOH-5139 -  changes TWO forms used to prove disability, including approval of Supplemental Needs Trusts including Pooled Trusts, MBI-WPD, and other situations in this article.  Replaces the LDSS-1151 form with the DOH-5139 form which can be downloaded here.   Also requires using a new DOH HIPPA form -- DOH-5173 (4/2016) -  for the disability determinations, but should still also include the OCA Official Form 960 - NY State HIPAA  since that is what HRA and other LDSS use.  Though the Alert is issued by HRA, it appears to convey new Statewide  policy and forms.

2021-07-22 NYC Medicaid Alert: New Home Care Services Program (HCSP) Inquiry Email Address - Inquiries related to HCSP Medicaid case transactions (including demographic changes, address updates, pooled trust reviews, county-to-county transfer requests, Medicare Savings Program (MSP) and coverage updates) may be sent via email to hcspinquiries@hra.nyc.gov.  This email is NOT for submitting applications or documents related to an application.  Encrypted email and information required.

2021-07-22 NYC Medicaid Alert: Substantial Home Equity - As of January 2021, the Home Equity value limit was increased from its 2020 level of $893,000 to $906,000.

2021-07-21 NYC Medicaid Alert: MAP Undercare Division - SEE UPDATED 9/8/21 Alert)Case action update requests (including demographic changes, change of address, transfer from county-to-county requests and coverage updates) may be sent via email to undercareproviderrelations@hra.nyc.gov.  Encrypted email with applicable  MAP 751K or MAP 751W  form required. 

  • These forms are both posted in multiple languageson HRA site here, which says the forms may also be faxed to 1-917-639-0837.    
  • Or download fill-in-able MAP-751k (3/15/21) and MAP-751W  (3/25/21) in English. 
  •  This undercare email address is NOT for new applications, which the general public in NYC should fax to

2021-03-26 IRS Form 1095B No Longer Automatically Mailed

The IRS Form 1095B will no longer be automatically mailed to everyone enrolled in Medicaid, Child Health Plus, or the Essential Plan. Consumers can still request a copy of the form. 


2020-12-22 Asset Verification System Expanded to all DAB/SSI Related Submissions

Beginning 1/1/21 the Asset Verification System (AVS) will be used to determine Medicaid eligibility for all new community Medicaid applications. AVS electronically verifies accounts held in banking institutions or real property owned by the applicant. Applicants AND their spouse must authorize electronic verification as a condition of eligibility, regardless of the level of coverage they are seeking.  AVS has been required since 2017 to verify bank accounts  or real property owned by the applicant.  See 17ADM-02 - Asset Verification System  with attachments here.  NYC HRA has implemented this gradually - first in Nursing Homes in 2018 , then in hospital applications in 2019., and  now  in community applications. 

The Supplement A Form must be used for all applications for those age 65+, disabled or blind, and must be signed by the applicant and spouse, even if spouse is  not applying or doing spousal refusal. A new Supplement A is now required in NYC -  DOH-5178A,  This form was previously used outside NYC but is new for NYC.  See this article for more about using the new Supplement A form starting in January 2021. 

2020-12-17 Medicare Savings Program Applications Client Rep

Authorized client reps can submit MSP applications can be submitted via fax to 917-639-0731

2020-10-28 Closing of Metropolitan Medicaid Office

States Metropolitan Medicaid Office (located at 1901 First Avenue, 1st floor. New York, NY 10029) will permanently close on October 30, 2020. The staff from this office will be reassigned to the Manhattanville Community Medicaid Office.

Also indicates that 12 month automatic renewal process has been extended to cases with authorizations ending in November & December

2020-05-28 Defective Renewal Notices During COVID-19 Emergency

During the week of May 18-23, notices were sent in error to consumers whose renewals were due in May 2020, informing them that their Medicaid case would be closed. However, the cases will not be closed and coverage will be extended, regardless of if the renewal was returned. A new notice will be sent to clients informing them that their case will remain open. 

2020-05-27 REVISED Fax Submissions to MICSA & HCSP updates alerts issued May 4, 2020 and April 16, 2020

HRA strongly encourages the submission of Medicaid applications and other documents via e-fax instead of mail. This alert provides instructions and fax numbers for each unit. The 5/27 alert includes phone number for physicians to provide verbal orders (instead of submitting a written M11q form) and a corrected fax number for Nursing Home Eligibility Division (NHED).  Includes fax number for Hospital Eligibility Division & Prenatal Care and Assistance Program. 

2020-03-23 NYC Medicaid Alert: Relocation of North Central Bronx Medicaid Office

The office will be relocated and renamed: Fordham Medicaid Office, 2541-2549 Bainbridge Avenue, 3rd floor, Bronx NY 10458


2019-12-05  Hospital Applications - Asset Verification System -  MICSA Alert: Asset Verification System (AVS) Expanded to Hospital Eligibility and Client Representative Case Submissions -

Expands AVS that was previously only for  Nursing Home applications in NYC - 2018-04-09   Nursing Home Applications   -  Asset Verification System (AVS)  

NYC Medicaid Office Relocations:

  • 2019-12-12   NYC Medicaid Alert: Relocation of Brooklyn CASA Office --The Brooklyn CASA office will be relocated to: 88 Third Avenue, 3rd floor, Brooklyn NY 11217

  •  2019-08-26 Jamaica Community Medicaid Office -- A new Medicaid office will open in Jamaica Queens at 165-08 88th Avenue, 8th floor, Jamaica NY 11432. The office will be opened on 9/9/19

  • 2019-09-03 Relocation/Rename of Lincoln Medicaid Office - The current Medicaid office located at Lincoln Hospital in the Bronx will be relocated and renamed to: Rider Medicaid Office, 305 Rider Ave, 4th floor, Bronx NY 10451. The current office will close on 8/27/2019 and open in the new location on 9/30/2019. 

2019-08-22 RENEWALS  NYC Medicaid Alert: Elimination of MAP 2097K

MAP 2097K form will no longer be required for renewals. Includes sample renewal packet. 

2019-07-31  RENEWALS   NYC Medicaid Alert: Reapplication and Renewal Grace Period

This alert reiterates an existing policy which states that if a Medicaid case is closed for failure to renew, consumers have a  30 day grace period to submit their renewal and their case will be reopened. In addition, if a Medicaid application is rejected due to failure to provide documentation, the applicant can submit the requested information within 30 days without a completely new application. 

2019-06-04   RENEWALS   NYC Medicaid Alert: Notification Regarding Eligibility Renewal Packets

This alert states that a technical issue has impacted the May 2019 mailing of New York City WMS eligibility renewal packets. Consumers who were supposed to receive their renewal in May will now receive it in June. Their coverage will be extended to ensure they have time to complete the renewal process. 

2019-04-09  DISABILITY DETERMINATIONS + POOLED TRUSTS  NYC Medicaid Alert: Disability Determination Packet Update and Appropriate DOC TYPE for EDITS Submitters

Identifies the documents needed when applying for a disability determination for adults and children. The MAP 751E form, "Authorization to Release Medical Information" is now required for all disability determination requests. 


2018-12-31    NYC Medicaid Alert: 12/31/18 - NYC HRA Contacts in Medicaid and Home Care Services Programs 

2018-12-28    2019 Medicaid Income and Resource Levels

2018-12-18    Change in Email address to send HRA Office of Legal Affairs Draft SNTs for Review  (not where to submit executed pooled trusts, which should be sent to Medicaid office handling the Medicaid application/renewal).  

2018-07-28    Special Income Standard for Housing Expenses for Individuals  Discharged from a Nursing Facility and
                      who Enroll into the  MLTC Program
  - update on previous policy. See this article

2018-07-03  "RosenbergMedicaid Determinations after Public Assistance Discontinued - Shifted to NYS of Health

The "Rosenberg" procedure is used when public assistance cash benefits are terminated, to allow the individual to recertify and maintain Medicaid without disruption if they are still eligible. See more here.  Initially this change applies to Singles and Childless Couples, and not to anyone in an MLTC plan or HARP plan. Those affected will receive a letter from HRA telling them they must renew their Medicaid online on NYS of Health. The Alert includes the form letter.

2018-06-25   Pooled Trusts (SNT)        Deferral of SNT's Submitted with Invalid Power Of Attorney

THIS DIRECTIVE IS VOID under  GIS 20 MA/03 – Clarification of GIS 19 MA/04, “Clarification of Policy for Treatment of Income Placed in Medicaid Exception Trusts”   A statutory gift rider is NOT required for enrolling a pooled trust or SNT with a Power of Attorney. See more here about the directive and how it came about from advocacy from the NYS Bar Association Elder Law & Special Needs Section. 

2018-04-26   Pooled Trusts (SNT)     Disability Form Completion when Submitting Pooled Trusts over age 65

Reminder to submit completed LDSS-1151 (revised 6/2012) with pooled trusts for those over age 65, or under 65 if they are not receiving SSD/SSI benefits.  Implies that must complete Work History section even if work done more than 15 years ago, but don't have to enter physical demands of job if more than 15 years ago.  Says should not cross out entire work section even if no work done in last 15 years.  

2018-04-09   Nursing Home Applications   -  Asset Verification System (AVS) - 

NYC rolling out  Asset Verification System (AVS) that has been rolled out statewide.   So far in NYC used in Nursing Home applications only, not in Community Medicaid applications. This system applies only in "non-MAGI" cases, meaning for people age 65+, disabled, or blind. This is because MAGI cases (< 65 and not on Medicare) do not have any asset limit.


2017-12-13   Applications/Eligibility Requirements  Medicare Enrollment Required.   See this article for more info. 

2017-12-04   Applications        Application Dates and Deferral Timeframes - Changes deadline for applicants to respond 
                                                   to a "deferral" or request by local DSS for additional documents to support application. 
                                                   Everyone gets 15 calendar days to respond, except for nursing home applicants  (5-year
                                                   lookback) get 21 calendar days.  Consumer may request an extension by submitting new
                                                   form  MAP-3062a manually to the department where they submitted application. 
                                                   Decision granting or denying extension will be on form MAP-3062b (sample attached to                                                     the Alert.

2017-07-26    Pooled Trusts    Powers of Attorney and Statutory Gift Rider -

THIS DIRECTIVE IS VOID under  GIS 20 MA/03 – Clarification of GIS 19 MA/04, “Clarification of Policy for Treatment of Income Placed in Medicaid Exception Trusts”   A statutory gift rider is NOT required for enrolling a pooled trust or SNT with a Power of Attorney. See more here about the directive and how it came about from advocacy from the NYS Bar Association Elder Law & Special Needs Section. 

2017-05-11   Renewals            Revised Disabled, Aged, Blind (DAB) Renewal Form and On-line Reprints of DAB on                                                            www.nyc.gov/accessnyc

2017-04-26    Transportation   New Contractor for NYC Medicaid transportation - LogistiCare - (formerly MAS - Medical Answering Services LLC)  Has contact info.


2016-12-15 Changes in Medicaid Coverage for Temporary Non-Immigrants Temporary Non-Immigrants

2016-09-23   Medicaid Applications & Personal   Immediate Need Applications - Personal Care and CDPAP
                   Care  & CDPAP                                      Procedure and Transmittal Form HCSP 3052

2016-04-04  HIPAA Release         MAP-751d Authorization for Disclosure of Health Information replaced by   
                                                       OCA Form No. 960 - Authorization for Release of Health Information Pursuant to                                                                     HIPAA   Download Alert here.


2015-10-28  Nursing Home & Managed Care    Nursing Home Transition into Managed Care:  Forms & PDF Training Material  (lists new forms which are attached in PDF including:

  • MAP 259d - Discharge Alert for Non-Chronic Care Budget (Community Budgeting)(10-2015 revised)
  • MAP 259e (Change in Discharge Plan)
  • MAP 259f (Discharge Notice)(revised 7/31/2018)
  • MAP 259g (Respite care)
  • MAP-259t - Request to Convert Case (Revised 5/29//2020)
  • MAP-2159 Notification of Change or Correction to File from nursing facility
  • MAP-2150i Notice of Permanent Placement - Medicaid Managed Care (revised 10/5/2015)
  • MAP2159W Permanent Placement Disenrollment Request
  • MAP-648p  - Submission of Request from RHCF - Residential Health Care Facility (revised 5/10/2019)
  • NOTE - references PowerPoint which is not attached but posted here)

2015-10-26 Nursing Home & Managed Care - MICSA/NHED Submission Protocol for Transition of Nursing Home Benefit  into Medicaid Managed Care

2015-08-31   Spend-Down/ Surplus  NYC MICSA Alerts 8/31/15 & 5/18/15 re Payment of Surplus Bills or Pay-in by Third Parties with accompanying form MAP-3107a Attestation of Use of Recipient Funds to pay Surplus

2015-06-15 Nursing Home       MAP-648 P Nursing Home Medicaid Transmittal

2015-06-03 MA Eligibility-MAGI        Treatment of Income of a Dependent under MAGI-Like Budgeting.  Implements NYS DOH GIS GIS 15 MA/008 - Treatment of Income of Dependents Under MAGI-like Rules  PDF 

2015-06-02  Nursing Home       Policy Change for the Start Date of the Transfer of Assets Look Back Period

2015-03-10  MA Eligibility        Newborn Processing Update

2015-04-27  MA Eligibility        MAPDR-01  2014 NYS Medicaid Income & Resource Standards with Federal Poverty 
                                                       Levels (new version includes MAGI as well as NON-MAGI income levels)

2015-04-03 Nursing Home       Transition of Long Term Nursing Home Benefit into Medicaid Managed Care

2015-03-31 Nursing Home       Nursing Home Eligibility Division Expedited Renewal Protocol

2015-03-10   Transition Exchange to LDSS  Consumers with Medicaid on Exchange Needing Enrollment into MLTC or

                       HIV SNP (updates previous alert 1/10/2015 and 6/11/2014)

2015-03-10 MA Eligibility         Automated Newborn Processing on WMS 

2015-02-20 MA Eligibility         Reinstatement of Suspended Medicaid Coverage for Formerly Incarcerated Individuals

2015-02-03  MA Eligibility        Medicaid Recipients Transferred at Renewal from NYS of Health to Local Dept. of Soc. Services

Procedure for transitioning people from expanded "MAGI" Medicaid generally for people under 65 who do not have Medicare -- when they turn 65 or become enrolled in Medicare, they must transfer to Non-MAGI Medicaid, using a stricter income and resource test.   The procedure provides some coverage to fill the gap during the transition.  It implements State DOH 14-LCM-02   PDF  (Dec. 2014) with Attachments to State DOH LCM:

  • Attachment I -Renewal form notice language and Medicaid Renewal Form
  • Attachment II - Statewide Provider IDs (Medicaid managed care plans)
  • Attachment III - Recipient Referral Information - Data Elements

2015-01-26 MLTC                      CASA Fact Sheet

2015-01-05 MA Eligibility          Consumers Transition from NYSOH to WMS update (UPDATED 3/10/2015)


2014-10-24  MA Eligibility          MAGI Consumers Long Term Eligibility Rules
2014-09-26  MA Procedures       Incorrect Stenson Notices to Some (2500) SSI Consumers
                                                       Be MAGI Eligible (PDF includes FORM 3097)


2013-12-24  Nursing Home Budgeting    2013 MAP-INF 04:  Spousal Refusal Instructions - Supplement to MAP
                    Spousal Impoverishment                                   Procedure 90-10 (community spouse entitled to spousal impoverishment monthly  income allowance (CSMIA) even if does spousal refusal as to assets) (revised per Esnard letter)

2013-12-24  MA Eligibility            Important Changes in Medicaid Application Submissions-MAGI & Non-MAGI

2013-12-20  MA Eligibility            Substantial Home Equity (Nursing Home and Community-Based LTC)

2013-12-16  MLTC                        Spousal Impoverishment & Transfer of Assets for Certain Individuals Enrolled in MLTC

2013-12-13  Transportation         Public Transportation Reimbursement Change

2013-11-13  MLTC                         FAQ - procedures for MLTC plans to enroll members who have a spend-down. 

2013-10-1    Health Exchange     NYS Health Benefit Exchange Opens October 1, 2013

2013-05-13  Renewals                 Automated Renewal Some DAB Consumers with Fixed social Security Income 

2013-8-13    MLTC                       Disenrolled Housekeeping Case Consumers (MLTC)

2013-5-6     Office Relocation     PHASE V-Relocation of MICSA 34th Street Offices to Brooklyn

2013-5-1     Office Relocation     SPECIAL TBI & NHTD-Relocation fo MICSA 34th Street Office to Brooklyn

2013-4-30   Office Relocation     PHASE IV-Relocation of MICSA 34th Street Offices to Brookyn

2013-4-24   Office Relocation     PHASE II-III-Relocation of MICSA 34th Street Offices to Brooklyn

2013-4-18   LTHHCP\Lombardi   Mandatory Enrollment of LTHHCP Consumers in Managed Care

2013-4-16   Office Relocation     PHASE I-Relocation of MICSA 34th Street Offices to Brooklyn

2013-4-3    Office Relocation      Relocation of MICSA 34th Street Offices to Brooklyn

2013-3-05   MA Eligibility  Social Security Verification--No Proof of SSA Income Required at Applications or Renewals

2013-2-19   MLTC              Special Income Standard for Housing Expenses for Individuals Discharged from NH to MLTC

2013-2-14   MLTC               MLTC Submissions of Nursing Home Enrollments 

                    MLTC FORM       ** References Form HCSP-3022 known as MLTC Conversion Form (9/26/2013)

2013-1-24   Pooled Trusts Medical Evidence Gathering for Adult Disability Determinations


2012-12-28  Transportation                
2012-11-02 Hurricane Relief                 Medicaid Coverage - Hurricane Sandy 
  • CDPAP must be accessed through Medicaid managed care plans effective 11/1/12 for those enrolled in these plans (people with Medicaid but not Medicare statewide), or through Managed Long Term Care plans, for people who have Medicaid and Medicare in NYC
2012-09-21 Renewals                             RENEWAL STATUS INFORMATION FOR MEDICAID CONSUMERS (status of renewal available
for calling HRA Helpline 1-888-692-6116
2012-09-19  Managed Care                    Ending Managed Care Exemption for "Waiver Look-Alikes" - but allowing 6-month exemption for 
 people not in but applying for a  waiver

2012-09-06  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-07-03  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-03-27  Managed Care            MAPDR-21  Medicaid Managed Care Exemptions and Exclusions            


2011-12-30 MANUAL MAILING -      Discontinued Manual Mailing of Medicaid Alerts

2011-05-03  RENEWALS -               Expansion of Attestation of Income, Resources, and Residence for  SSI-related (DAB) Renewals

Announces expansion of ability to "attest," rather than verify with documentation, certain eligibility criteria during the annual renewals for Medicaid for "DAB" population - Disabled, Aged 65+, Blind.  May attest to income, resources, and change of residency.  This includes those receiving Community-Based Long-Term Care Services, which is new.  

2011-03-16 MEDICAID FAIR HEARINGS Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn


2010-07-02  APPLICATIONS                  Financial Maintenance Requirements for Medicaid and Family Health Plus       

2010-07-01  APPLICATIONS                  Revisions to Health Insurance Application 4220 and Access NY Supplement A

2010-06-30  CITIZENSHIP PROOF         Puerto Rican Birth Certificates

                                                       DOH 4471 Certification of Treatment of an Emergency Medical Condition Replaces MAP 2151

2010-04-26  APPLICATIONS                  Elimination of the Face to Face Interview for Medicaid Family Health Plus applicants

2010-02-26   UNDOCUMENTED IMMIGRANTS   Temporary Protected Status for Undocumented Haitian Immigrants

2010-01        2010 INCOME LEVELS     Medicaid Income and Resource Levels 2010

2010-01       MEDICARE SAVINGS PROGRAM  Disregard of Income Placed in Pooled Trust when Applying for MSP Program

2010-01        RESOURCE LEVELS         Elimination of Resource Limit for Non-SSI Related Medicaid


2008-11-03 APPLICATIONS                Change of Submission Location for Client Reps

2008-06-10  ELIGIBILITY                       NYC Eliminates Drug and Alcohol Screening

2008-06-10  RESOURCE LEVELS        Resource Level Raised to $13,050

2008-04-08 RECERTIFICATIONS         Mail Renewal 30 Day Grace Period

2008-04-08  APPLICATIONS                MSP Applications Done Now by Mail 

2008-04-08  APPLICATIONS               Elimination of the Resource Test for MSP Program


2006-10-06   RECERTIFICATIONS        Introduction of MAP-909E DAB Mail Renewal Form

2006-04-26   POOLED TRUSTS            Instructions for Submitting Supplemental Needs Trusts 


2005-07-07   POOLED TRUSTS            Disability Determinations for Individuals with a Pooled Trust


2004-06-21   BURIAL ACCOUNTS      Irrevocable Pre-Need Funeral Agreements and Burial Funds

2004-05         POOLED TRUSTS           Supplemental Needs Trusts Excluded from Medicaid Eligibility Budgeting


2001-05-30   NURSING HOMES            Nursing Home Expedited Discharge Program 

MEDICAID HOME CARE - NOTE - not updated since 2012 - see above section

DATE            TOPIC                                     TITLE


2012-10-26  Home Care, Managed Care Consumer-Directed Personal Assistance Program (CDPAP) and Managed Care               
  • CDPAP must be accessed through Medicaid managed care plans effective 11/1/12 for those enrolled in these plans (people with Medicaid but not Medicare statewide), or through Managed Long Term Care plans, for people who have Medicaid and Medicare in NYC)
2012-09-19  Managed Care                  Ending Managed Care Exemption for "Waiver Look-Alikes" - but allowing 6-month exemption for 
 people not in but applying for a  waiver  (this affects some Medicaid personal care recipients receiving CASA home care who in summer/fall 2012 are receiving notices that their exemption from managed care has ended and they must join a mainstream managed care plan

2012-09-06  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-07-03  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care


2011-05-02  CASA III Relocated            Merger of CASA III with CASA V

2011-03-16  Home Care Fair Hearings Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn


2010-08-25  Applications                      Relocation and New Address of Central Intake Office to Submit M11Q


2009-11-05 APPLICATIONS                    Revised MIIQ for Home Care


2008-04      RECERTIFICATIONS            Mail Renewal 30 Day Grace Period


DATE            TOPIC                                     TITLE

2015-03-26 Office Relocation   Relocation of HRA Division of Accounts Receivable and Billing (DARB)

2015-03-26 Office Relocation   Relocation of HRA Headquarters to 4 World Trade Center



2013-9-18       CASA Field Offices                    CASA Directory


2012-11-02 Hurricane Relief                 Medicaid Coverage - Hurricane Sandy 


2011-03-16   OFFICE MOVED             Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn


2010-10-14 OFFICE MOVED              Relocation of the CASA VII Office.

2010-10-12 OFFICE MOVED              Relocation of the Long Term Health Care Program Brooklyn Units 

2010-08-25 OFFICE MOVED              Relocation of HCSP, Central Intake and BMPR

2010-04-22 CONTACT LIST              Updated Nursing Home Eligibility Division Telephone and Address Directory

2010-03-16 CONTACT LIST              New Contact Numbers for MAP Dialysis Unit 


2009-09-11 OFFICE MOVED             NYC Health and Human Services has new office at 622 W 168th St Manhattan 

2011-05-02  CASA III Relocated            Merger of CASA III with CASA V
Attached files
item 2024-01-23 Submission of the DOH-4220 Application's Appropriate Pages.pdf (125 kb) Download
item 2023-12-28 Contact Information Update for the Medical Assistance.pdf (136 kb) Download
item 2023-6-30 unwinding of medicaid continuous coverage.pdf (161 kb) Download
item 2013-06-03 Automated Renewal DAB Consumers Fixed Income.pdf (134 kb) Download
item CASA List (HCSP-3037 English) 12-4-2023.pdf (74 kb) Download
item MAPDR-21 Medicaid Managed Care Exemptions and Exclusions 9-28-2015.pdf (71 kb) Download
item HRA Medicaid Alert SNT 4-26-06.pdf (47 kb) Download
item Medicaid phone list.pdf (224 kb) Download
item MAP-259d-e-f-g-t Discharge Alert and Related Nursing Home Forms as of 2023-03-24 (259f -259t+ 648p).pdf (3.04 mb) Download
item HRA MICSA Alert Relocation of HCSP, Central Intake and BMPR August 25, 2010_101018125105.pdf (52 kb) Download
item HRA MICSA Alert Mail Renewal 30 Day Grace Period 4-1-08_110201134237.pdf (392 kb) Download
item HRA MICSA Alert Relocation of Fair Hearing and Conference Unit 03-2011.pdf (44 kb) Download
item Alert 5-2-11 CASA III Move.pdf (36 kb) Download
item Medicaid Alert Mandatory MLTC Update 9-6-2012.pdf (118 kb) Download
item Alert 2012-9-19 Managed Care Waiver Lookalikes Exemption.pdf (51 kb) Download
item MICSA Hurricane.pdf (130 kb) Download
item 2012-10-26 CDPAP and Managed Care.pdf (117 kb) Download
item NYC HRA Medicaid Alert - Renewal Status Information for Medicaid Consumers 9-21-12.pdf (56 kb) Download
item 2012-11-07 - Sandy Relocate DARB Pay-In.pdf (316 kb) Download
item 2012-11-13 - Sandy Relocate DARB Pay-In AMENDED.pdf (261 kb) Download
item 2001_to_2023_NYS_income__resource_level_charts.pdf (3.52 mb) Download
item Medicaid Alert Special Income Standard for housing expenses NH-MLTC 2-9-2013.pdf (85 kb) Download
item MAP-3057E Special income housing Expenses NH-MLTC.pdf (490 kb) Download
item Medicaid Alert No Proof of SSA income required 3-2013.pdf (337 kb) Download
item Medicaid Alert--Medical Evidence Disability 1-2013.pdf (428 kb) Download
item 2013-04-18 lombardi mltc.pdf (102 kb) Download
item MICSA Transportation NYC.pdf (324 kb) Download
item Medicaid Alert Relocation of MICSA Units to Brooklyn Phase I 4-16-2013.pdf (52 kb) Download
item Medicaid Alert Relocation of MICSA units to Brooklyn II 4-24-13.pdf (360 kb) Download
item Medicaid Alert Relocation of MICSA units to brooklyn IV 4-30-13.pdf (43 kb) Download
item Medicaid Alert Relocation of MICSA units to Brooklyn Special 5-1-13.pdf (47 kb) Download
item Medicaid Alert Relocation of MICSA units to Brooklyn V 5-6-13.pdf (135 kb) Download
item Disenrolled Housekeeping Case Consumers (MLTC) 8-13-13.pdf (65 kb) Download
item MLTC Submissions of Nursing Home Enrollments 2-14-13.pdf (287 kb) Download
item 2020-09 NYC Home Care Services Program -CASA directory.pdf (309 kb) Download
item Esnard Letter 2013-12-23 CSMIA.pdf (79 kb) Download
item 2013_12_17 MLTC Spousal Impoverishment.pdf (374 kb) Download
item 2013-10-1 NYS Health Benefit Exchange Opens 10-1-13.pdf (284 kb) Download
item 2013-12-13 Public Transportation Reimbursment Change.pdf (117 kb) Download
item 2013-12-20 Substantial Home Equity (NH and CBLTC).pdf (109 kb) Download
item 2013-12-24 Important Changes in Medicaid Application Submissions-MAGI and Non-MAGI.pdf (93 kb) Download
item 2013 MAP INF-04 Spousal Impoverishment Correction.pdf (36 kb) Download
item 2014-06-11 Transition coverage from NYSOH to WMS.pdf (286 kb) Download
item 2014-09-26 Incorrect Stenson Notices SSI State Takeover.pdf (54 kb) Download
item 2014-08-26 Request for Rebudgeting to MAGI from Spend-Down.pdf (116 kb) Download
item 2015-02-03 Medicaid Recipients Transferred at Renewal from the New York State of Health to the Local Department of Social Services.pdf (143 kb) Download
item 2015-03-10 CORRECTED UPDATE Transition coverage from NYSOH to WMS with copy of 2014-06 Original Alert + Transmittal form.pdf (505 kb) Download
item 15-03-26 Relocation of HRA Headquarters.pdf (266 kb) Download
item 15-03-26 Relocation of HRA DARB.pdf (276 kb) Download
item 2015-03-31 NHED EXPEDITED RENEWAL PROTOCOL.pdf (200 kb) Download
item 2015-03-10 Automated Newborn Processing on WMS.pdf (210 kb) Download
item 2015-02-20 Reinstatement of Suspended Medicaid Coverage for Formerly Incarcerated Individuals.pdf (457 kb) Download
item 2015-04-03 Transition of Long Term Nursing Home Benefit into Medicaid Managed Care.pdf (690 kb) Download
item CASA FAct Sheet 2015.doc (30 kb) Download
item 2015-01-05 Consumers transitioned from NYSOH to WMS update (HIV SNP).pdf (53 kb) Download
item 2014-12-09 8 Helpful HInts re Completion M11q.pdf (61 kb) Download
item 2014-10-24 MAGI Consumers Long Term Eligibility Rules.pdf (74 kb) Download
item 2015-05-06 Newborn Processing Update.pdf (191 kb) Download
item 2014-06-10 Submission Application Reconsideration and Reapp Requests.pdf (60 kb) Download
item MAP-3069b 2014-05-01 Request for Agency Conference (Non-Edits and Edits combined).pdf (73 kb) Download
item MICSA-NHED Submission Protocol Transition of NH into MMC-MLTC 10-26-15.pdf (794 kb) Download
item 2015-06-03 Treatment of Income of a Dependent under MAGI-Like Budgeting Rules.pdf (207 kb) Download
item 2015-08-31 Mailing of Notices to Excess Income Consumers re 3rd party payment of surplus.pdf (506 kb) Download
item MAP 751d is replaced by OCA 960 form.pdf (1.18 mb) Download
item 2016-10-19 Immediate Need for PCS and CDPAP.pdf (220 kb) Download
item 2016-09-23 Immediate Need transmittal Form.pdf (225 kb) Download
item 2016-12-15 MA Alert re Temporary Non-Immigrants dated 12-15-16.pdf (188 kb) Download
item 2017-04 Medicaid Alert re Transportation for FFS and MMC New Company.pdf (192 kb) Download
item MAS transportation.pdf (191 kb) Download
item 2017-07-26 Power of Attorney and Statutory Gifts Rider.pdf (74 kb) Download
item 2017-05-11 Revised DAB Renewal Form and Online Reprints of DAB Renewal.pdf (755 kb) Download
item 2017-12-13 - Must Apply for Medicare.pdf (139 kb) Download
item 2017-12-04 Medicaid Application Dates & Deferral Timeframes.pdf (174 kb) Download
item MAP-3062a Request for a Time Extension (12-5-17) Fillable.pdf (66 kb) Download
item 2018-06-25 POA Deferring Medicaid Apps - POA not auth for SNT.pdf (63 kb) Download
item 2018-04-09 Asset Verification System.pdf (928 kb) Download
item 2018-07-03 Transition of Rosenberg Determ's for MAGI S-CC to NYSofHealth.pdf (94 kb) Download
item 2018-04-26 Disability Form completion for Pooled Trust Submission.pdf (148 kb) Download
item 2018-07-26 Medicaid Alert - Special Income Standard for Discharge from NH to MLTC.pdf (303 kb) Download
item 2018-12-31 HRA Medicaid & HCSP Contacts for Authorized Submitters and CBO's.pdf (93 kb) Download
item 2018-12-18 Referrals of Draft SNTs to Office of Legal Affairs (OLA) Change of Email address.pdf (176 kb) Download
item 2021-09-27 Transitioning of MAGI - Like Medicaid Cases.pdf (213 kb) Download
item 2021-08-30 Fax-e-Mail submissions to MAP - Home Care Services Preogram.pdf (152 kb) Download
item 2023-01-25 COVID-19 Program Modifications.pdf (82 kb) Download
item 2019-12-5 Asset Verification System (AVS) Expanded to Hospital Eligibility Submissions.pdf (136 kb) Download
item 2021-09-08 MAP Undercare Division email REVISED +751k -751w forms.pdf (539 kb) Download
item 2021-07-22 HCSP inquiries by email.pdf (129 kb) Download
item 2021-08-12 Disability Determination Form LDSS-1151 Replaced by DOH-5139.pdf (142 kb) Download
item 2021-09-22 Reopening of Chinatown Medicaid Office.pdf (78 kb) Download
item 2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers.pdf (124 kb) Download
item 2021-10-29 Medicaid Surplus Coverage Update.pdf (789 kb) Download
item DOH-5143 Replaces 486T Medical Report for Determination of Disability (08-2018) - FILLABLE.pdf (50 kb) Download
item 2021-12-20 Medical Disability Form LDSS-486T Replaced with DOH-5143.pdf (718 kb) Download
item 2022-02-04 Changes to LDSS-3183 Provider or MLTC Plan & Recipient Letter.pdf (810 kb) Download
item 2022-03-24 Revised DOH-4220 Access NY Health Care Application.pdf (136 kb) Download
item DOH form 4220_updated 8-2021.pdf (619 kb) Download
item DOH form 5130_updated 9-2021.pdf (23 kb) Download
item 2022-05-13 New York Independent Assessor.pdf (93 kb) Download
item 2022-6-30 MA Alert Disability Determination by New York State Medicaid.pdf (148 kb) Download
item 2022-12-27 Non-MAGI Eligibility Increases 2023- with REVISED map-3190 (1-10-23).pdf (827 kb) Download
item 2023-03-31 Transition of the Pharmacy Benefit from Managed Care to NYRx.pdf (159 kb) Download
item 2023-04-7 Access HRA Client Portal Enhancements.pdf (250 kb) Download
item 2023-05-31 NYIA and Changes to Personal Care Assessment Process.pdf (132 kb) Download

Also read
item How to use a pooled SNT to eliminate the Medicaid spend-down.
item Applying for Medicaid Personal Care Services and CDPAP Outside NYC - 2016 Changes
item Medicaid Consumer Directed Personal Assistance Program (CDPAP) in New York State
item The Medicaid Pharmacy Benefit - For People Without Medicare - NYRx Implemented April 1, 2023
item Managed Long Term Care
item Medicaid Disability Determinations - NYS Forms & Procedures (with updated forms Dec. 2021)
item Medicaid Managed Care
item Applying for Medicaid Personal Care or CDPAP Services in New York City - 2021-2022 Changes
item Medicaid Contacts in New York City (NYC Human Resources Administration - MICSA)
item Medicaid Renewals/Recertifications in NYC- Resume March 2023 - Now can file online!

Also listed in
folder Medicaid -> Getting Started
folder Medicaid -> Financial Eligibility
folder Medicaid -> Other Services
folder Medicaid -> Supplemental Needs Trusts
folder Medicaid -> Home Care
folder Medicaid -> Medicaid Managed Care
folder Medicaid -> Immigrant Access
folder Research and Advocacy Tips
folder Medicaid -> Applying For and Keeping Medicaid
folder Medicaid -> NYC Medicaid Contacts, Policies & Forms

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