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HRA MICSA Alert - Changes in Pooled Trust Unit Download
2016-6-7 Pooled Trust Unit Liaison and Contact information.pdf
Organizational change in Pooled Trust Unit at HRA for NON-home care cases. This unit does not process trusts for home care cases. See http://www.wnylc.com/health/entry/44/ for those contacts
13 Jun, 2016 131 kb Downloads: 7240
NYC MICSA Alerts 8/31/15 & 5/18/15 re Payment of Surplus Bills or Pay-in by Third Parties Download
2015-08-31 Mailing of Notices to Excess Income Consumers re 3rd party payment of surplus.pdf
Both Alerts in one PDF with accompanying Form MAP-3107A Attestation of Use of Recipient Funds
22 Nov, 2015 506 kb Downloads: 10373
NYC HRA Medicaid MICSA Alert June 3, 2015 - Treatment of Income of Dependents for MAGI-Like Budgeting Download
2015-06-03 Treatment of Income of a Dependent under MAGI-Like Budgeting Rules.pdf
Implements NYS DOH GIS 15 MA-08 which clarified that child dependents' Social Security or other income should not be counted in MAGI-like budgeting, which local districts must do when a person eligible under the MAGI category needs long term car and some other instances, for which eligibility must be processed by the local district rather than the Exchange.
22 Nov, 2015 207 kb Downloads: 3989
NYC HRA MICSA/NHED Submission Protocol - Transition of Nursing Home Benefits into Medicaid Managed Care Download
MICSA-NHED Submission Protocol Transition of NH into MMC-MLTC 10-26-15.pdf
Official training PowerPoint for MLTC and Managed care plans, nursing homes and NYC Medicaid staff on submission of Medicaid applications for nursing home care under new 2015 changes requiring permanent nursing home residents to enroll in or stay in managed care or mLTC plans. October 2015.
22 Nov, 2015 794 kb Downloads: 21682
NYC HRA MICSA Form MAP-3069b Request for Agency Conference Download
MAP-3069b 2014-05-01 Request for Agency Conference (Non-Edits and Edits combined).pdf
Form renamed in 2014 - formerly known as Request for Reconsideration. 2 versions of form are in this PDF - One is "Non-EDITs" and one is "EDITS."
25 Sep, 2015 73 kb Downloads: 4347
June 10, 2014 HRA MICSA Alert - Submission of Medicaid Application Reconsideration and Reapplication Requests Download
2014-06-10 Submission Application Reconsideration and Reapp Requests.pdf
Notifies outside submitters of changes to HRA’s process for submitting case reconsideration and reapplication requests. Both processes are being standardized across the Medical Insurance and Community Service Administration’s (MICSA’s) Divisions, with the exception of the Nursing Home Division. The reconsideration process is also being renamed as a
Request for an Agency Conference. MICSA’s Reconsideration Request form (MAP-3069b) has been renamed to “Request for an Agency Conference.” It replaces forms MAP-751, MAP-751a, MAP-751h and MAP-751j which
were previously used by various MICSA divisions to accept requests for case reconsiderations.
25 Sep, 2015 60 kb Downloads: 5283
MICSA - Renewal Status File Download
HRA Presentation to MLTC Plans - Renewal Status File.pdf
Presentation from NYC Human Resources Administration to managed care plans on the NYC process for helping managed care plans work with their members to renew Medicaid coverage. Describes renewal timeline in general, as well as special weekly data file (RS) sent to plans to help them identify members who need follow-up. May 14, 2012.
27 Jul, 2015 171 kb Downloads: 3336
NYC HRA MICSA Alert - Renewal Status Information for Medicaid Recipients (9/21/2012) Download
NYC HRA Medicaid Alert - Renewal Status Information for Medicaid Consumers 9-21-12.pdf
reminder that renewal status information is available for Medicaid clients through HRA’s Medicaid Helpline (888-692-6116). This status is available through an Interactive Voice Response System (IVRS) and is updated daily. By entering a client’s social security number and date of birth into IVRS, the caller can obtain information on the status of a client’s renewal:

Whether or not HRA has received a renewal from the client,
Status of HRA’s processing of the renewal and
The eligibility decision if the renewal has been processed.

The system is being upgraded and will, in the next few months, also allow the option of using case number to receive information.
27 Jul, 2015 56 kb Downloads: 5948
Policy Change for the Start Date of the Transfer of Assets Look Back Period Download
2015-06-02 Policy Change for the Start Date of the Transfer of Assets Look Back Period.pdf
Effectively immediately, the review of assets is limited to the 60-month period immediately preceding the month of institutionalization and application for Medicaid.

For Medicaid recipients who are institutionalized for long-term nursing home care or receiving more than 29 days of rehabilitation services, the look-back period consists of the 60 months preceding the month of institutionalization.
02 Jun, 2015 308 kb Downloads: 4068
Form M-11q - Medical Request for Home Care (12-9-014) Download
HCSP-M11q (12-9-2014)Fill-in-able.2.pdf
This is the form used by the New York City Human Resources Administration for doctors to request personal care services through Medicaid for people who are excluded or exempt from Managed Long Term Care. This means it is for people in the OPWDD, TBI or NHTDW waivers, who require only Housekeeping services of up to 8 hours/week or who are under age 21. The form was updated 12/2014. This is a fillable version. THe original PDF can be downloaded at http://www.nyc.gov/html/hra/downloads/pdf/services/micsa/m_11q.pdf.
21 May, 2015 137 kb Downloads: 51100
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