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NYC Medicaid Alert - Fair Hearing Relocation Update July 25, 2025
2025-07-25 HRA MAP fair hearing relocation update.pdf
Annouces relocation of certain NYC HRA Fair Hearing units within NYC. This is not about where the STATE Fair Hearing office is in NYC - but the NYC HRA Medicaid division that produces case files for Medicaid fair hearings, handles compliance, aid continuing, and represents HRA at fair hearings. -- All contacts posted at http://health.wnylc.com/health/entry/216/#Fair%20Hearings
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29 Jul, 2025
159 kb
Downloads: 80
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Medicaid Alert: Excess Income (Surplus) Applicants in Need of Managed Long Term Care
2012-07-12 Excess Income (Surplus) Applicants in need of MLTC.pdf
July 12, 2012
The purpose of this ALERT is to inform Community Based Organizations, Client Representatives, Certified Home Health Agencies and other providers that the Medical Assistance Program is changing the way it processes Medicaid applications for excess income eligible consumers seeking enrollment into a Managed Long Term Care (MLTC) plan. Consumers seeking MLTC enrollment who are found to only be eligible for the Medicaid Excess Income (Surplus) Program will now have their cases accepted and authorized with “06” (provisional) coverage. This will occur even if their applications are received without bills that cover their excess or surplus.
This new process will allow MLTCplans to see the provisional coverage on ePaces/eMedNY and will facilitate receipt of services for these consumers. Submitters are requested, when appropriate, to prominently indicate on the cover sheet of submitted applications that the consumer intends to enroll into an MLTC plan
Current policy will remain unchanged for all other consumers found eligible for the Excess Income Program.
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10 Jul, 2025
42 kb
Downloads: 12882
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HRA Medicaid Alert -Office of Medicaid Renewal - fax/email contacts to submit Renewals, applications, and other requests (6/3/2025)
2025-06-03 MAP Office of Mail Renewal -submission information.pdf
Fax numbers, e-mail addresses and mail addresses to submit Medicaid renewals, applications, and other requests. June 3, 2025. Contacts are/will be added to this HRA contact list posted at http://health.wnylc.com/health/entry/216/
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19 Jun, 2025
441 kb
Downloads: 491
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MAP-909E HRA DAB Renewal Form Redacted (2023-12-06)
MAP-909e DAB Renewal (2023-12-06) Sample with 2023 ACT NOW insert_Redacted.pdf
HRA Medicaid Renewal Form for Disabled, Aged, & Blind (DAB) recipients - 12/6/2023 version
(1) a 2-page Renewal Notification letter with the deadline to return the renewal, which is always the 10th of the 2nd month after the notification,
(2) "STOP ACT NOW" alert intended to alert consumers that this renewal MUST be returned, unlike those sent during the Public Health Emergency (MAP-3185 - 2025-01-09),
(3) Renewal form has a new section in Part 6 RESOURCES requiring authorization for HRA to verify resources using data matching - must be signeded by recipient and spouse(page 7, 12-13 of the PDF);
(4) Renewal form must be signed by both applicant and spouse (p. 15 of PDF)
(5) Financial Maintenance form - not new - only required if housing costs are more than 70% gross monthly income (p. 10 of PDF);
(6) Renewal instructions (pp. 15-17 of PDF)
(7) Bar coded return envelope - LAST PAGE of PDF. If you don't have this, mail it to the address on this copy CERTIFIED.
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13 May, 2025
2.89 mb
Downloads: 19073
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HRA Medicaid Alert 3/19/2025 - NYS Disability Determination Requirements
2025-03-19 State Disability Determination Requirements.pdf
This alert reiterates the previous Alert dated April 18, 2024 and one earlier in 2022. When requesting a Disability Determination, submit only MAP-3177 Disability Determination request. HRA will forward this to the NYS Disability REview Unit, which will then request the rest of the documents listed in this article - http://health.wnylc.com/health/entry/134/.
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16 Apr, 2025
123 kb
Downloads: 232
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HRA Medicaid Alert 4/15/2025 - New Fax Numbers for Home Care Services Program Central Intake
2025-04-15 HCSP homecare Central Intake number change.pdf
NEW Fax numbers for Home Care Services Program at NYC HRA Medicaid CENTRAL INTAKE, Use for
submission of NYIA decision "OUTCOME" otfices for adult applicants if NYIA denied MLTC enrollment and refers back to local district to request HOUSEKEEPING services (limited to 8 hours/week), and to submit M11Qs for applicants under 18, and to submit change requests on active cases, and reauthorizations of CASA cases.
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16 Apr, 2025
84 kb
Downloads: 442
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NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2024
2001_to_2024_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2024. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
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07 Mar, 2025
3.77 mb
Downloads: 302807
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Medicaid income and resource levels - 2025 (2-14-2025)
MAPDR-01 Feb 26 2025.pdf
NYC HRA MAPDR-01 (updated 02-14-2025) -- Although this was issued in Feb. 2025, almost all the figures are in yellow which means that they are still the 2024 figures. The 2025 figures can only be calculated after NYS Dept. of Health issues the 2025 Federal Poverty Levels (FPL) later in February or March (even though the FPLs were announced by the federal govt).
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26 Feb, 2025
2.13 mb
Downloads: 453554
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MAP-751W Consumer/Provider Request to Change Information on File (11-25-2024)(fill-able)
MAP-751W Request to Change Information (Doc required) (11-25-2024).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. may be faxed to Fax 1-917-646-0837 per August 2024 Medicaid Alert http://www.wnylc.com/health/download/738/. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K. The 2018 version of the MAP-751W is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages - but has not yet been updated to the 2024 version as of 1/23/25.
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20 Feb, 2025
186 kb
Downloads: 10702
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HRA-MAP 931Y E-Fax Medical Bills Cover Sheet (2018)
MAP-931Y_E-Fax_Medical_Bills 2018-4-27.pdf
HRA Medicaid Fax Cover Sheet to Fax medical bills to meet spend-down (2018)
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29 Jan, 2025
80 kb
Downloads: 25901
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