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Medicaid income and resource levels - 2023 (06-06-23)
HRA MAPDR-01 2023 Income-Resource Levels (06-06-2023).pdf
NYC HRA MAPDR-01 (updated4-5-2023) -- 2023 NYS Income and Resource Standards revised. Note these now use 2023 Federal Poverty Levels so should be the FINAL figures for 2023.
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06 Jun, 2023
303 kb
Downloads: 436674
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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: 462
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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: 60083
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MAP-909E DAB Renewal Form Redacted (2022-01-04)
MAP-909e DAB Renewal (2022-01-04) Redacted Sample with 2023 ACT NOW insert.pdf
HRA Medicaid Renewal Form being sent in 2023 to Disabled, Aged, & Blind (DAB) recipients in the "unwinding" of the Public Health Emergency. Note that the packet contains
(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) "ACT NOW" alert intended to alert consumers that this renewal MUST be returned, unlike those sent during the Public Health Emergency (MAP-3185 - 2023-01-19),
(3) Renewal form has a new section in Part 6 RESOURCES requiring authorization for HRA to verify resources using data matching (page 6 of the PDF);
(4) Renewal form must be signed by both applicant and spouse (p. 9 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) NEW: Authorization for Verification of Resources - Recipient and Spouse each must sign this and send back with renewal!
(MAP-3179 and 3179a) (pp. 11-13 of PDF)
(7) Renewal instructions (pp. 14-16 of PDF)
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31 May, 2023
2.17 mb
Downloads: 7674
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Stenson - Sample Notice of Discontinuance for Failure to Return Stenson Renewal
Disco notice after Stenson packet not received - 2023 Redacted.pdf
Sample notice of intent to discontinue Medicaid, where former SSI recipient failed to return a renewal package to renew Medicaid as a separate stand-alone benefit from SSI. Redacted.
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27 Mar, 2023
2.25 mb
Downloads: 325
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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: 9758
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12-22-22 HRA Medicaid Alert - Eligibility increases starting Jan. 2023 & REVISED MAP-3190 Form to Request Re-budgeting
2022-12-27 Non-MAGI Eligibility Increases 2023- with REVISED map-3190 (1-10-23).pdf
HRA Medicaid Alert announcing the increases in income and asset eligibility for Age 65+, Disabled & Blind recipients starting Jan. 2023. NYLAG has swapped in HRA's iupdated form MAP-3190 form (rev. 1-10-23) that will be mailed to everyone with a spend-down starting Jan. 30, 2023. The form can be completed and returned to HRA to request a decreease in the spend-down. See more at http://www.wnylc.com/health/news/90/#II.%20Timing
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28 Jan, 2023
827 kb
Downloads: 3208
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NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2022
2001_to_2022_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2022. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
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21 Jan, 2023
3.78 mb
Downloads: 298765
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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: 6498
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NYC Medicaid Alert 6-30-2022 - Change in Submissions to HRA for Disability Determination for Pooled Trusts & MBI-WPD (revises 5/31/22 Alert)
2022-6-30 MA Alert Disability Determination by New York State Medicaid.pdf
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
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01 Jul, 2022
148 kb
Downloads: 1846
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