Updated 2023 using the 2022 FPLs. We hope to update it again when DOH adopts the 2023 FPLS.

Eff. June 1, 2022, submissions to HRA to approve a Pooled Trust or MBI-WPD no longer need to include the disability forms (DOH-5141, DOH-5143, Authorization MAO-751e, AIDS report form MAP 252F. Instead, once the pooled trust is filed with HRA, HRA will route it to NYS DOH Disabilitiy Review Team, which will then request MAP 3177 Disability Determination Request from the consumer. Unclear if other documentation will be required but likely - stay tuned look for updates at http://www.wnylc.com/health/entry/44/ (This revises the Alert issued May 31, 2022

NYLAG Health Priorities for NYS Budget 2022-23 - including expansion of the Medicaid financial limits for age 65 and disabled, and Medicare Savings Program expansion, and more

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
C. DAC

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.

PowerPoint describes the changes in Medicaid Home Care that started being rolled out Nov. 8, 2021. This PowerPoint developed before DOH launched website about Independent Assessor that starts March 1, 2022, so does not include that info posted at https://www.health.ny.gov/health_care/medicaid/redesign/nyia/. Check for more updates at http://www.wnylc.com/health/news/85/. Webinar recording will also be posted. Proposed expansion of financial eligibility for age 65+, disabled, and blind is also discussed.

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. Link to NYC CityPay website (https://a836-citypay.nyc.gov/) is provided. Medical bills cannot be submitted through this website.

Powerpoint with latest info - as of Oct. 20, 2021 -- on implementation of changes enacted in the NYS FY 2020-2021 budget, including the restrictions on eligibility for Personal Care services (PCS) and CDPAP services (reqiring 2-3 ADLs), the Independent Assessor procedures, and the loosened standards allowing plans to more easily reduce hours of home care after a "transition period" for certain members.

Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)