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2021-10-29 Medicaid Surplus Coverage Update Download
2021-10-29 Medicaid Surplus Coverage Update.pdf
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.
16 Nov, 2021 789 kb Downloads: 1926
2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers Download
2021-10-28 DARB Online Payment Option for Medicaid Excess Income Consumers.pdf
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.
16 Nov, 2021 124 kb Downloads: 4044
Transitioning of MAGI-like Medicaid Cases from DSS/HRA Medicaid to NYSOH Download
2021-09-27 Transitioning of MAGI - Like Medicaid Cases.pdf
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.
06 Oct, 2021 213 kb Downloads: 3912
2021-9-08 MAP Undercare Division - Case Action Update Requests via Email Download
2021-09-08 MAP Undercare Division email REVISED +751k -751w forms.pdf
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
12 Sep, 2021 539 kb Downloads: 4161
HRA Medicaid alert 2020-05-27 Authorized Client Representatives - COVID-19 Application Submissions by E-fax Download
2020-05-27 Fax Submissions to MICSA & HCSP.pdf
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)
04 Sep, 2021 46 kb Downloads: 2691
HRA MICSA Alert 8-12-2021 Disability Determination Form LDSS-1151 Replaced with DOH-5139 Download
2021-08-12 Disability Determination Form LDSS-1151 Replaced by DOH-5139.pdf
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
13 Aug, 2021 142 kb Downloads: 3748
CASA Directory Updated 9-09-2020 (Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
CASA field offices have been consolidated. There is one CASA office per borough. Includes announcement of new email address for HCSP inquiries
04 Aug, 2021 309 kb Downloads: 7225
Contact List of CASA Offices - Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)
04 Aug, 2021 309 kb Downloads: 37091
2021-7-22 MAP New Home Care Services Program Inquiry Email Address Download
2021-07-22 HCSP inquiries by email.pdf
This Alert is to advise Medicaid Providers, Hospitals, Client Representatives, Community Based Organizations, Certified Home Health Agencies(CHHA), and Advocates, that the Home Care Services Program (HCSP) has created an email inbox to allow for the submission of inquiries related to HCSP Medicaid case transactions using hcspinquiries@hra.nyc.gov. Allowed inquiries/transaction include demographic changes, address updates, pooled trust review, county-to-county transfer requests, Medicare Savings Program and coverage updates. This email is NOT FOR SUBMITTING APPLICATIONS or documents related to an application. Please read Alert for required information.
26 Jul, 2021 129 kb Downloads: 2700
MAP-751k (Spanish)(3-15-2021) Download
MAP-751K (3-15-2021)(Spanish).pdf
NYC HRA Form to use to notify HRA of change in name, address, mailing address, date of birth, SSN, and to request mail in different languages or formats for disability (Updated 3-15-2021) NOTE: The 751k is no longer used to request a change in budgeting. Instead use new form MAP-751W available at https://www1.nyc.gov/site/hra/help/health-assistance.page in various languages.
31 Mar, 2021 75 kb Downloads: 1872
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