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NYC HRA Medicaid Alert NY Independent Assessor & Changes to Personal Care (PCS) Assessment Process (5/31/23)
2023-05-31 NYIA and Changes to Personal Care Assessment Process.pdf
Explains what consumers seeking Medicaid CDPAP or personal care (PCS) should do in 2 situations: (1) Those who contacted NYIA directly, rather than applying for Immediate Need services and who are not in a Mainstream Medicaid managed care plan (known as "Fee for service (FFS) consumers") - If the NYIA notice says they are not eligible to enroll in MLTC and refers them to the LDSS - they should fax a copy of their NYIA decision notice to the CASA Central Intake unit (718) 636-7784. Case will be assigned to a CASA to use the notice to retrieve the NYIA assessments and then proceed to assess whether eligible for PCS or CDPAPt. But.. if they are a dual eligible and not in a hospice program, or in OPWDD, TBI or NHTD waiver - they are probably only eligible for 8 hours/WEEK of Housekeeping services from CASA. T
(2) If you applied to HRA for Immediate Need services - PCS or CDPAP via eFax (917) 639-0665 - you should not have to contact the HRA Home Care Services Program/CASA after the NYIA assessessments -- because NYIA should notify CASA of the outcome of the assessments directly and they should contact you about next steps to decide if you are eligible for services and if so - what is your plan of care.
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03 Jun, 2023
132 kb
Downloads: 60
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MAPDR-05 (08/04/2022) List of Managed Care & Managed Long Term Care Plans in NYC
2022-08-04 MAPDR-05 Medicaid Managed Care Plans NYC.pdf
This includes a list of all managed care organizations participating in the following types of Medicaid managed care, including ID and code numbers, contact information, and service areas:
* Medicaid Managed Care
* Health and Recovery Plan Managed Care Plans (HARP)
* Managed Long Term Care (MLTC)
* Medicaid Advantage Plus (for dual eligibles, includes MLTC)
* HIV Special Needs Plans (SNP)
* Programs of All-inclusive Care for the Elderly (PACE)
* Fully Integrated Dual Advantage (FIDA) IDD
Updated August 4, 2022 (current on HRA site as of 5/31/23)
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31 May, 2023
129 kb
Downloads: 59519
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MAP-648 P SUBMISSION OF REQUEST FROM RESIDENTIAL HEALTH CARE FACILITIES (RHCF)(05/05/2022)
MAP-648p Submission of request from RHCF-NH 2022-05-05.pdf
Transmittal form for Nursing Home to submit to HRA: new Medicaid application, request to convert coverage from community Medicaid, upgrade coverage, or notify HRA that transfer penalty period expired. (updated 5/5/2022)
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25 Mar, 2023
69 kb
Downloads: 9535
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List of 2023 Medicare Special Needs Plans (SNPs) in NYS
2023 New York State Special Needs Plans updated 3-6-23.xlsx
List of 2023 Medicare Special Needs Plans (SNPs) in NYS. Indicates whether plan is aligned with and part of a Medicaid Advantage Plus (MAP) plan (includes MLTC plan in same plan) or an IB-Dual plan (Integrated benefit - Dual) which is a type of a Medicaid managed care plan for people who have Medicare. These plans are subject to Default Enrollment. See http://health.wnylc.com/health/entry/226/. List updated in March 2023 with new plans and counties using Default Enrollment.
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06 Mar, 2023
74 kb
Downloads: 467
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Basic Eligibility for Medicaid and Home Care in NYS - Age 65+, Disabled, Blind
Medicaid Basic - 2023 FINAL (2-17-2023).pdf
This is basic general information about applying for Community Medicaid in order to receive home care (personal care or consumer-directed personal assistance) through Managed Long Term Care or based on Immediate Need through the local Medicaid program. To receive Medicaid home care, you must be both financially and medically eligible. This explains the rules on financial eligibility for the Disabled, Aged 65+, and Blind (DAB) category and gives info on how to apply (updated Feb. 17, 2023 with final 2023 Income and Asset limits released by DOH)
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18 Feb, 2023
312 kb
Downloads: 184512
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NYLAG PowerPoint on NY Independent Assessor - Feb. 2023
NYIA Webinar CLE Slides Handout 2-2023.pdf
Presentation given in webinar conducted by NYLAG Evelyn Frank Legal Resources Program on Feb. 8, 2023 on the NY Independent Assessor.
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15 Feb, 2023
1.99 mb
Downloads: 518
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NYLAG PowerPoint on NY Independent Assessor - and other Home Care Changes 2022
NYLAG NYIA for CDPAANYS 10-2022 - corrected.pdf
NYLAG Slides on NY Independent Assessor - and other Medicaid and Home Care Changes 2022 - current as of 10/27/2022, based on regulations and DOH policies slides posted at https://www.health.ny.gov/health_care/medicaid/redesign/nyia/repository/index.htm \ See more info and updates at http://www.wnylc.com/health/news/85/
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05 Dec, 2022
384 kb
Downloads: 2067
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MAP-751W Consumer/Provider Request to Change Information on File (3-25-21)(fill-able)
MAP-751W Request to Change Information (3-25-21) (fill-able)(with 3-4-22 memo where to submit).pdf
NYC HRA Form to notify HRA of corrections or changes, e.g. close case, combine case, add/remove individual, notify of death, change in immigration status, upgrade eligibility, request MSP evaluation, budgeting changes, pooled trust budgeting and add/remove third party health insurance. Per attached 3/2022 memo may be faxed to (917) 639-0837 or mailed. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K. The MAP-751W is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages.
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24 Oct, 2022
376 kb
Downloads: 5924
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Know Your Rights: Is Your MLTC Plan Closing? Know Your Rights - August 2022
MLTC Plan Closings (2022).pdf
Fact Sheet by NYLAG Evelyn Frank Legal Resources Program explaining the "transition rights" of MLTC members when their MLTC plan closes.
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01 Aug, 2022
1.01 mb
Downloads: 1701
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Fact Sheet on Continuity of Care or Transition Rights - After You Enroll in an MLTC Plan (updated 8/1/22)
Transition Period changes Fact Sheet - updated 8-1-22.pdf
If you received Immediate Need home care, or your MLTC plan closed, or you were disenrolled from your MLTC plan involuntarily, you are required to enroll in or switch MLTC plans. You have "continuity" or "transition" rights in your new MLTC plan. Learn about those rights and current changes in the rules for what happens when the "Transition Period" ends after 90-120 days.
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01 Aug, 2022
950 kb
Downloads: 2747
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