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HCSP 3026 ALP Medicaid Cover Sheet
HCSP-3026 HCSP Cover Sheet for ALP-MLTC 1-26-2015.pdf
This is the cover sheet for HRA-ALP Medicaid Cover Sheet
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13 Apr, 2015
44 kb
Downloads: 3513
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Notice of Admission/Discharge for the Assisted Living Program
HCSP 3027 1-26-2015.pdf
This form is to be mailed to Home Care Services Program once a client is admitted or discharged from Assisted Living Programs
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13 Apr, 2015
44 kb
Downloads: 3751
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15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical & Medical Facilities
15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical and Medical Facilities.pdf
This informational letter provides social services districts with updated charts that represent the monthly Personal Needs Allowance, PNAs, for residents of non-medical facilities the PNAs in medical facilities.
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13 Apr, 2015
302 kb
Downloads: 3099
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MAP-259H Consumer Intent to Return/Not Return Home
MAP-259H Intent to Return Home 2008-06-20.pdf
This form is used when a client enters a residential facility and makes a determination that he/she will either return or not return home.
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13 Apr, 2015
236 kb
Downloads: 4820
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Agreement to Participate in the Medicaid Pay-In Program
MAP-931B Agreement to Participate in Pay-In Program searchable pdf.pdf
This is the form in both English & Spanish agreeing to participate in the Medicaid Pay-In Program
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13 Apr, 2015
86 kb
Downloads: 3338
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Optional Pay-In Program for Individuals with Excess Income
MAP-931A Optional Pay-In Program searchable pdf.pdf
This explains the Excess Income Program for clients whose incomes exceeds the Medical Assistance income limits
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13 Apr, 2015
142 kb
Downloads: 3059
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Notice of Acceptance of your Medical Assistance Application/Recertification
MAP-259p_redacted.pdf
This is a redacted MAP-259p form to act as a guide for purposes of Medical Assistance application/recertification
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13 Apr, 2015
334 kb
Downloads: 3864
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Notice of Permanent Placement Medicaid Managed Care
MAP-2159i Notice of Permanent Placement Medicaid Managed Care.pdf
NYC HRA uploaded this form on 4/3/15 to be used for clients requiring permanent placement under Medicaid's managed care plan.
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13 Apr, 2015
36 kb
Downloads: 7125
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MAGI Consumers Long Term Eligibility Rules
2014-10-24 MAGI Consumers Long Term Eligibility Rules.pdf
long term eligibility rules for individuals who are eligible for Medicaid under a Modified Adjusted Gross Income (MAGI) eligibility group
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09 Apr, 2015
74 kb
Downloads: 5714
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Transition of Long Term Nursing Home Benefit into Medicaid Managed Care
2015-04-03 Transition of Long Term Nursing Home Benefit into Medicaid Managed Care.pdf
Update on the transition of long term nursing home benefit into Medicaid Managed Care. : Eligible nursing home
consumers age 21 and over, unless otherwise exempt or excluded, who become permanent placed in a nursing facility are required to enroll in or remain enrolled in a managed care plan to receive this benefit, includes those who are Mainstream Managed Care, Managed Long Term Care Plans, and Fee for Service Plans.
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03 Apr, 2015
690 kb
Downloads: 16645
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