2021-12-28 Usage of DOH 5178A Medicaid Application Supplement and DOH 4495A – New Medicaid Applications in NYC must be accompanied by DOH 5178A Supplement A form, even if the applicant is attesting the amount of their resources. The old form (DOH 4495A) will be accepted provided it is accompanied by DOH 5148 or DOH 5149. As of March 1, 2022, only the DOH-5178A will be accepted.

Announces mass mailing to all NYC Medicaid recipients asking them to report any address changes and certain other changes that occurred during the pandemic with Form 751K. Updating addresses is important because once the pandemic is declared over, all recipients will receive Renewal notices by mail. Without an updated address, they will not receive these renewals, and Medicaid could be discontinued. Form 751-k can be downloaded at http://www.wnylc.com/health/download/638/ (fillable) or in varioius languages at https://www1.nyc.gov/site/hra/help/health-assistance.page.

Announces a change in the form for treating physician to certify disability as needed to approve supplemental needs trusts including pooled trusts, and Medicaid based on disability, if not certified by the SSA. Replaces Form 486T, though 486T will be accepted until Feb. 1, 2022. New form posted at http://www.wnylc.com/health/download/798/

2021-10-29 Medicaid Surplus Coverage Update – During the Covid Health Emergency, surplus consumers must continue to meet their surplus requirement and, upon payment, should contact the Surplus Hotline to report that a payment was made. If consumers cannot make a surplus payment or their income have gone down, they should have their case re-budgeted. If they are unable to submit payment because of health issues related to Covid-19, such as quarantine or hospitalization, they can attest by calling the Surplus Hotline.

2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers - provides instructions for Online Credit Card payment to the Division of Accounts Receivable and Billing (DARB) to participate in the Medicaid Pay-In Program. Link to NYC CityPay website (https://a836-citypay.nyc.gov/) is provided. Medical bills cannot be submitted through this website.

Since the New York State of Health was introduced in 2014, it has been responsible for all MAGI Medicaid cases. However, there were many Medicaid consumers with MAGI-like budgeting who were found eligible before January 1st, 2014. Their cases have remained with HRA until they could be transitioned. Those consumers were to be transitioned in phases and the first transition began in June 2018. NYS has resumed the transition and approx. 158,600 individuals transitioned between April 2021 through July 2021. The alert details which groups of MAGI recipients were transitioned and those who will not be transitioned. Clients will not be required to renew their coverage in NYSOH until after the COVID-19 Health Emergency ends.

This Alert is to advise Medicaid Providers, Hospitals, Client Representatives, Community Based Organizations and Advocates that the Medical Assistance Program's Undercare Division can now receive case action update requests via email at undercareproviderrelations@hra.nyc.gov. This email is NOT FOR NEW APPLICATIONS. MAP 751k or 751w form attached to this alert is required. This alert revises the July 2021 alert

Updates alert from April 2020 with additional e-fax numbers.. Establishes new e-Fax number for "C-Rep" Authorized client Representatives for Medicaid applications not submitted electronically by EDITS. e-Fax 917-639-0731.

Requests ONE application be submitted per fax, with cover page listing all documents attached. Says not for MLTC application submissions (unclear what this means)

Announces TWO new forms to request a determination of disability for a pooled trust/ Supplemental Needs Trust, MBI-WPD and other reasons. The Disability Determination Form LDSS-1151is being replaced with DOH-5139 (download at https://www.health.ny.gov/forms/doh-5139.pdf). A new HIIPPA form must also be submitted https://www.health.ny.gov/forms/doh-5173.pdf - along with the OCA form used by the local districts. - https://www.nycourts.gov/forms/Hipaa_fillable.pdf

CASA field offices have been consolidated. There is one CASA office per borough. Includes announcement of new email address for HCSP inquiries