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Disabled Adult Child Medicaid Extensions/Continuations Download
DAC -Pickle- 1619B Chart (OCRed).pdf
This chart discusses the Medicaid Extensions/Continuations for certain special cases of SSI recipients once their SSI has been terminated. Specifically, it compares the eligibility criteria, resource/income levels, residential program requirements, spendown/NAMI contributions, reinstatement, and Medicare Buy-IN eligibility for the following groups:
A. 1619B
B. Pickle
22 Mar, 2022 103 kb Downloads: 7361
2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers Download
2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers.pdf
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. Link to NYC CityPay website (https://a836-citypay.nyc.gov/) is provided. Medical bills cannot be submitted through this website.
16 Nov, 2021 124 kb Downloads: 2314
2021-08-30 Updated Fax & E-maikl Submissions to HRA Medicaid and HCSP Download
2021-08-30 Fax-e-Mail submissions to MAP - Home Care Services Preogram.pdf
updates earlier fax lists - allowing submission of applications and other documents by fax during COVID-19 emergency, and adds some email addresses for inquiries
04 Sep, 2021 152 kb Downloads: 5199
Nassau County Physician's Request for Personal Care Aide and Orders to the Service Agency (07-2020) Download
Physician's Order Nassau County Form 517 - (2020).pdf
Form for doctor to complete to request Medicaid personal care services and CDPAP from the Nassau County DSS. Revised July 2020.
26 Aug, 2021 1.46 mb Downloads: 10202
CASA Directory Updated 9-09-2020 (Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
CASA field offices have been consolidated. There is one CASA office per borough. Includes announcement of new email address for HCSP inquiries
04 Aug, 2021 309 kb Downloads: 6343
Contact List of CASA Offices - Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)
04 Aug, 2021 309 kb Downloads: 33893
MAP-751K Consumer Request to Change Information on File (3-15-21)(fill-able) Download
MAP-751K (3-15-2021)(English)(fill-able).pdf
NYC HRA Form to use to notify HRA of change in name, address, mailing address, date of birth, SSN, and to request mail in different languages or formats for disability (Updated 3-15-21). The MAP-751K is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages. Upon completion, it can be faxed to HRA using 917-639-0837. (Updated 2-18-2021) NOTE: The 751k is no longer used to request a change in budgeting. For that, use new form MAP-751W posted at the same webpage as above for the 751K.
16 May, 2021 89 kb Downloads: 8363
2020-06-22 NYS Medicaid Program Modifications COVID-19 Emergency Download
2020-06-22 NYS Medicaid program Modifications COVID-19 Emergency.pdf
23 Jun, 2020 253 kb Downloads: 1940
2020-05-28 Defective Renewal Notices During COVID-19 Emergency Download
2020-05-28 Defective Renewal Notices.pdf
HRA Alert about notices sent in error to 30,000+ Medicaid recipients in NYC discontinuing Medicaid. The alert has the language of the correction notices that the consumers will receive.
31 May, 2020 78 kb Downloads: 2102
2019-12-12 Relocation of Brooklyn CASA Office Download
2019-12-12 Relocation of Brooklyn CASA office.pdf
30 Mar, 2020 96 kb Downloads: 1615
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