MICSA Alert 10-1-13 explaining the opening of the NYS health benefit exchange and some basic eligibility criteria.

MICSA Alert issued 12-16-2013 explaining spousal impoverishment option for certain MLTC enrollees and the requirement that the local districts apply institutional eligibility rules, including transfer of assets provisions, when an MLTC enrollee is in receipt of long term nursing facility services.

Letter in response to 12/18/2013 letter sent by NYS Bar Association Elder Law Section demanding that HRA cease illegal practice of denying Community Spouse Monthly Income Allowance to community spouses who did a Spousal Refusal

PowerPoint was presented for certified Client Representatives who have completed a certification to be authorized submitters of Medicaid applications to HRA. However, information in this may be generally applicable.

Paper dated March 23, 2012 filed with US Center for Medicare & Medicaid Services and NYS Dept. of Health to incentivize community-based services in the roll-out to mandatory managed long term are.

Training provides framework for understanding the changes to Medicaid effective 2014, including: new categories, new income levels, new budgeting and new benefits.

FAQ clarifying issues that pose barriers to enrollment into MLTC plans. Many of these problems stem from "coding" problems - eligibility codes in the Medicaid "eMedNy" system. This FAQ explains that some codes may appear to say the individual is not eligible for Medicaid or for MLTC -- but THEY DO NOT MEAN THAT! And plan should submit "conversion package" to HRA to activate Medicaid and allow enrollment.

This table lists all of the types of resources (aka, assets) that are excluded for purposes of Medicaid eligibility, including which Medicaid categories they apply to, and citations to authority.
Do not use for MAGI Medicaid effective 1/1/2014.
Updated 10/7/2013.

Medicaid alert, dated Feb. 14, 2013, describing the process of enrolling a Nursing Home resident in an MLTC plan.

Special procedure for MLTC plans to submit "conversion" package to NYC HRA Medicaid program, to enroll residents of nursing homes who want to enroll in an MLTC plan in order to return to the community.

In all MLTC enrollments, the conversion package is a set of forms that HRA needs in order to make the necessary entries into the Medicaid eligibility and billing system, so that the enrollment takes effect on the 1st of the following month, and so the MLTC Plan is paid its capitation rate. Once in MLTC, the member will not be able to access Medicaid services in the MLTC service package outside the MLTC Plan's network.

For nursing home residents, the "conversion" is more complicated. HRA not only has to enter the codes described above but also has to remove the codes that applied because of the residence in the nursing home. For many years, nursing home residents have encountered delays in lifting the nursing home "code" from their eligibility, so that they could now access community-based home care and other medical services. The conversion package must include:

(1) The HCSP-3022 (Medicaid Cover Sheet) - This is the conversion form.. A copy is or will be posted on this website.
(2) Completed Nursing Home discharge Alert (MAP-259D)(posted at http://www.wnylc.com/health/download/132) and see article at http://www.wnylc.com/health/entry/117/ )
(3) A copy of the signed enrollment form
(4) A copy of the MAP-3057 (Special Income Standard) form, if applicable (posted at http://www.wnylc.com/health/download/398/) and described in http://www.wnylc.com/health/entry/114/ - last link in Table of Contents