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.

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/

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.

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/.

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. 

HRA Medicaid Fax Cover Sheet to Fax medical bills to meet spend-down (2018)

NYC procedures to implement change in state law giving full Medicaid coverage to Undocumented Immigrants Age 65+ - but only through Medicaid managed care plans. See article on this change at http://health.wnylc.com/health/entry/251/ with state directives.

MICSA Alert 8-2-2024 Relocation of Brooklyn South (MAIN) Medicaid Office and Authorized Rep Window - adds new email address for AUthorized Representatives (approved by HRA) to email applications.

HRA contacts for the New York City Home Care Services Program CASA offices (updated 12/2023)

Consumers who have their Medicaid coverage through the New York State of Health (the Marketplace) and who require certain services, must have their case transitioned to WMS (and administered by HRA) in order to receive those services. Amends and references an earlier Alert of June 2014, which is attached to this copy along with the Transmittal form annexted to the June 2014 Alert.