FAQ clarifying issues that pose barriers to enrollment into MLTC plans. Many of these problems stem from "coding" problems - eligibility codes in the Medicaid "eMedNy" system. This FAQ explains that some codes may appear to say the individual is not eligible for Medicaid or for MLTC -- but THEY DO NOT MEAN THAT! And plan should submit "conversion package" to HRA to activate Medicaid and allow enrollment.

Special procedure for MLTC plans to submit "conversion" package to NYC HRA Medicaid program, to enroll residents of nursing homes who want to enroll in an MLTC plan in order to return to the community.

In all MLTC enrollments, the conversion package is a set of forms that HRA needs in order to make the necessary entries into the Medicaid eligibility and billing system, so that the enrollment takes effect on the 1st of the following month, and so the MLTC Plan is paid its capitation rate. Once in MLTC, the member will not be able to access Medicaid services in the MLTC service package outside the MLTC Plan's network.

For nursing home residents, the "conversion" is more complicated. HRA not only has to enter the codes described above but also has to remove the codes that applied because of the residence in the nursing home. For many years, nursing home residents have encountered delays in lifting the nursing home "code" from their eligibility, so that they could now access community-based home care and other medical services. The conversion package must include:

(1) The HCSP-3022 (Medicaid Cover Sheet) - This is the conversion form.. A copy is or will be posted on this website.
(2) Completed Nursing Home discharge Alert (MAP-259D)(posted at http://www.wnylc.com/health/download/132) and see article at http://www.wnylc.com/health/entry/117/ )
(3) A copy of the signed enrollment form
(4) A copy of the MAP-3057 (Special Income Standard) form, if applicable (posted at http://www.wnylc.com/health/download/398/) and described in http://www.wnylc.com/health/entry/114/ - last link in Table of Contents

NYC Medicaid office moved from 330 West 34th Street to 785 Atlantic Avenue, Brooklyn NY 11238 in May 2013. Contact numbers at that office listed in this document.

8-13-13 MICSA Alert detailing the housekeeping conversion process to facilitate consumer disenrollment from MLTC plans to HRA.

Document MAP 931 (S)(Spanish) explaining Surplus Income Program, dated 8/2/2011

Information regarding relocation of MICSA 34th Street Offices to 785 Atlantic Avenue in Brooklyn.

Information regarding relocation of the Traumatic Brain Injury and Nursing Home Transition and Diversion waiver programs from 330 W. 34th Street to 785 Atlantic Ave.

Information regarding relocation of MICSA administrative offices from 34th Street to Atlantic Ave in Brooklyn.

Information regarding relocation of MICSA administrative offices from 34th Street to Atlantic Ave in Brooklyn.

Information concerning relocation of MICSA administrative offices from 330 W. 34th Street in Manhattan to 785 Atlantic Ave., Brooklyn NY 11238.