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HRA MICSA Alert 8-22-2019 Elimination of MAP 2097K - with sample of MAP 909e Renewal Form
2019-08-22 Elimination of MAP-2097K- with 909E Renewal Form.pdf
Says MAP-2097K Health Insurance Eligibility Screening Worksheet is obsolete. Alert includes sample of MAP 909E (4/19/18) which is still the renewal form used in NYC as of 3/30/21. Says renewals will be deferred if all pages not submitted. Note that Alert has no date but the HRA MARC website indicates date is 8/22/19.
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30 Mar, 2021
324 kb
Downloads: 4493
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MICSA Alert: Asset Verification System (AVS) Expanded to Hospital Eligibility and Client Representative Case Submissions
2019-12-5 Asset Verification System (AVS) Expanded to Hospital Eligibility Submissions.pdf
HRA MICSA Alert: Asset Verification System (AVS) Expanded to Hospital Eligibility and Client Representative Case Submissions (11/29/2019)(revised)
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23 Sep, 2020
136 kb
Downloads: 2701
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2020-05-28 Defective Renewal Notices During COVID-19 Emergency
2020-05-28 Defective Renewal Notices.pdf
HRA Alert about notices sent in error to 30,000+ Medicaid recipients in NYC discontinuing Medicaid. The alert has the language of the correction notices that the consumers will receive.
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31 May, 2020
78 kb
Downloads: 2882
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NYC HRA Medicaid Alert April 16, 2020
2020-04-16 Fax Submissions to MICSA & HCSP.pdf
HRA Alert with fax numbers for authorized submitters and providers to fax applications and other requests to various HRA Medicaid units - during the COVID-19 epidemic. The fax number posted at https://www1.nyc.gov/site/hra/locations/medicaid-locations.page for the PUBLIC to fax applications is not on this list - it is 917-639-0732
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17 Apr, 2020
172 kb
Downloads: 2546
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Sample NYC Stenson Notice (revised 2015) with Renewal form (revised 2013)
MAP-909 (English) Stenson Notice (1-15-2015) with 3074 form (10-16-2013).pdf
Notice used in NYC to advise a former SSI recipient of the procedure to have continuing Medicaid eligibility determined, with Renewal form to be completed and returned (MAP 909 and MAP 3074)
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15 Jan, 2020
2.02 mb
Downloads: 10699
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MAPDR-21 - Medicaid Managed Care Exemptions and Exclusions
MAPDR-21 Medicaid Managed Care Exemptions and Exclusions 9-28-2015.pdf
This documents lists which categories of beneficiaries are exempt or excluded from the requirement of joining a mainstream medicaid managed care plan. Rev'd 9/28/15
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03 Jan, 2020
71 kb
Downloads: 16690
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Consumer Directed Personal Assistance Application - NYC HRA Home Care Services Program
M-13d - CDPAP Application (2018-04) Fill-able.pdf
From M13d, rev. 4/2018, which a NYC consumer or person directing his/her care must complete and have approved by the CASA in order to enroll in the Consumer Directed Personal Assistance Program (CDPAP). Made fill-in-able by NYLAG EFLRP.
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22 Oct, 2019
151 kb
Downloads: 6969
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NYC HRA Explanation of Medicaid Pay-In Program for Spend-down updated 2019-03-22 (Bengali)
MAP-931a (Bengali) Optional Pay-in Program for Individuals with Surplus Income 2019-03-22.pdf
NYC HRA Explanation of Medicaid Pay-In Program for Spend-down updated 2019-03-22 (Bengali) to include State fact sheet on pooled trusts also available at http//health.ny.gov/health_care/Medicaid/index.htm#trusts. Note that the NYS Bar Association Elder Law Section has asked DOH to revise the pooled trust fact sheet to make it more clear. Other languages now posted on this site
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24 Aug, 2019
145 kb
Downloads: 3041
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MAP-931A Explanation of Medicaid Pay-In Program (English) (updated 2013-03-22)
MAP-931a (English) 2019-03-22.pdf
NYC HRA Explanation of Medicaid Pay-In Program for Spend-down updated 2019-03-22 (English) to include State fact sheet on pooled trusts also available at http//health.ny.gov/health_care/Medicaid/index.htm#trusts. Note that the NYS Bar Association Elder Law Section has asked DOH to revise the pooled trust fact sheet to make it more clear. Other languages now posted on this site
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24 Aug, 2019
59 kb
Downloads: 12758
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MAP-931A Explanation of Medicaid Pay-In Program for Spend-down (Urdu) 2019-03-22
MAP-931a (Urdu) Optional Pay-in Program for Individuals with Surplus Income 2019-03-22.pdf
MAP-931A Explanation of Medicaid Pay-In Program for Spend-down ( Urdu) 2019-03-22 updated to include State fact sheet on pooled trusts also available at http//health.ny.gov/health_care/Medicaid/index.htm#trusts. Note that the NYS Bar Association Elder Law Section has asked DOH to revise the pooled trust fact sheet to make it more clear.
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24 Aug, 2019
154 kb
Downloads: 2896
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