Medicaid Spend-down: NYC Medicaid Now Accepts FAXED Medical Bills

In May 2009, the NYC Medicaid Program announced a pilot program that allows consumers who must "spend down" to qualify for Medicaid to fax their medical bills each month to the Medicaid Centralized Surplus Unit.   See announcement.   You can download the official Spend-down fax cover sheet with the pre-printed fax number 917-639-0645.   HRA says the processing time is 4-5 days. 

Every fax should be sure to fill in the blanks for client's NAME and CIN, and also:   

• Is the bill paid or unpaid (though actually this shouldn't make any difference),   
• Specify which month to activate Medicaid for (this is generally the month in which the bill was incurred - but perhaps they are allowing longer budgeting periods)

If there are questions or problems, please e-mail Bernadette Brown

Note that people who participate in NYC's home attendant  (personal care) program through the CASA's  who have a spend-down do not need to fax their bills, since the bill they receive each month from their home care vendor satisfies the spend-down requirement.  Also, many people who receive home care through a Certified Home Health Agency (CHHA), or dialysis, may not need to use this procedure, since the CHHA or dialysis provider may be handling this monthly task for them --they should check with their CHHA or dialysis provider.

For more information, see Selfhelp's training materials on the Medicaid spend-down program. 

This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.