NYC form for a Medicaid applicant to authorize HRA to obtain protected health information from their medical providers for purposes of determining disability. This form was used for applicants for disability-based Medicaid (i.e., DAB or SSI-related category), for MBI-WPD, and for SNTs. (Rev'd 6/6/12). As of January 2013, this form should no longer be required, as the State now requests three signed copies of the OCA 960 HIPAA form instead.

Coalition to Protect the Rights of NYS Dual Eligibles Comments on State's revised proposal to coordinate Medicare and Medicaid services for dual eligibles, letter dated May 19, 2013. Issues include enrollment of nursing home residents and protections; objections to "passive enrollment" -- auto-assignment of people who don't voluntarily enroll; and incentives for plans to provide long term care services in the community rather than institutions.

This bill would correct two due process violations: (1) The lack of "aid continuing" pending an appeal when a managed care plan reduces or terminates home care or other services -- if the "authorization period" for the services has expired, there is a right to appeal but no right to aid continuing. This provides that aid continuing must be given regardless of whether the authorization period has expired. (2) In Managed long term care, consumers must "exhaust" internal appeals before requesting a hearing. This is not required in mainstream managed care, and results in dismissal of many valid appeals because consumers don't know that they must pursue this interim internal appeal.

State policy implementing expansion of mandatory enrollment of people needing permanent nursing home coverage into managed care and Managed Long Term Care (MLTC) plans. Mandate is to start April 1, 2014, subject to CMS approval not yet given as of March 13, 2014.

Obtained through freedom of information request by Urban Justice Center, Feb. 2014

Published in March 2014

Letter to HRA to cease the unlawful practice of denying this impoverishment income allowance to community spouses who did a spousal refusal. HRA responded and corrected its policy, provided spouse provides complete information regarding income and resources. For links to these documents and to the letters from the NYSBA and HRA, see http://www.wnylc.com/health/entry/96/

A community spouse is entitled to the community spouse monthly income allowance (CSMIA) even if she does a spousal refusal to contribute resources. See NYS ADM 91-ADM-33 and NYS DOH Medicaid Reference Guide at page 396. However, since mid-2012, the NYC HRA Medicaid program has violated this longstanding state rule and has denied the community spouse this income allowance if she executed a spousal refusal. Many fair hearing decisions reversed these determinations, see, e.g. FH 6208131N (3/1/2013), FH 6318971R (9/5/2013). In December 2013, the Elder Law Section of the NYS Bar Association asked HRA to cease this unlawful practice of denying this impoverishment allowance. Through a Freedom of Information request, the Bar identified some internal HRA procedures that were wrong and asked that HRA correct them. On Dec. 24, 2013, HRA issued 2013 MAP-INF 04 which correctly states that the community spouse is entitled to the CSMIA even if she does a spousal refusal, if she provides complete information regarding income and resources.

Practical Guide on getting Medicaid to reimburse for home care expenses incurred during the 3-month retroactive period, and during the pendency of the application, in New York City. Includes citations to pertinent case law and regulations.