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HSCP-3046 Home Care Services Program Cover Sheet
HCSP-3046 1-26-2015.pdf
This is the cover sheet to be used for Home Care Services Program
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13 Apr, 2015
38 kb
Downloads: 3785
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HCSP 3047 MLTC Cover Sheet
HCSP 3047 1-26-2015.pdf
This is the cover sheet to be used for MLTC cases
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13 Apr, 2015
44 kb
Downloads: 3836
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HSCP-3047b MLTC Nursing Home Eligibility Determination Cover Sheet
HCSP-3047b 1-26-2015.pdf
This is the cover sheet to used for MLTC NHED
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13 Apr, 2015
55 kb
Downloads: 5582
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HCSP-3047a MLTC/PRU
HCSP-3047a MLTC-PRU 1-26-15.pdf
This is the MLTC Provider Relations Unit cover sheet to be used
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13 Apr, 2015
47 kb
Downloads: 3661
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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: 3754
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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: 3976
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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: 5084
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CASA Fact Sheet
CASA FAct Sheet 2015.doc
Fact sheet describing what is covered under Housekeeping Services and where CASA offices are located
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09 Apr, 2015
30 kb
Downloads: 5429
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Fact Sheet on FIDA - by New York Legal Assistance Group
FIDA Fact Sheet NYC-Nassau (2015-4-1).pdf
Fact Sheet on FIDA with understanding of enrollment procedures as of Mar. 30, 2015. By NYLAG. Includes list of plans in Region 1 - NYC and Nassau. Revised to show enrollment postponed in Westchester and Suffolk
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01 Apr, 2015
690 kb
Downloads: 11340
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FIDA 30-Day Notice - 30 Days Before Passive Enrollment - Final Reminder notice
M6 - 30-day PE Reminder Notice -11.29.14.docx
The NYS Dept. of Health's notice sent by its contractor, NY Medicaid Choice (Maximus) 30-days prior to "passive enrollment" into a FIDA plan. This notice follows an "announcement" notice (https://www.health.ny.gov/health_care/medicaid/redesign/docs/fida_prog_announce_brooklyn.pdf) a 90-day and 60-day notice. Both the 60-day and 30-day notices tell you which FIDA plan you will be assigned to if you do not OPT OUT.
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25 Mar, 2015
37 kb
Downloads: 4743
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