NYLAG update presented in the 30th Elder Law Forum on May 15, 2025 sponsored by Pierro, Connor & Strauss LLP. Recording of this presentation will be posted soon. View PDF that includes all presentations at https://www.pierrolaw.com/wp-content/uploads/2025/05/Elder-Law-Forum-Presentation-2025.pdf.
TOPICS in this presentation:
1 -NYC Medicaid Cases Closing if Renewals Not Returned – 20,000 in first batch!
2- CDPAP Transition to PPL as Single “FI”
---Status, advocacy, health insurance, what is driving this?
3 -Recent & Upcoming MLTC Plan Mergers – Alert re Transition Rights
4 NYS Fair Hearing Backlog- “PHD” process 2025
5 Federal Medicaid Defense
6 On the horizon
---MECM – Medicaid applications moving online!
---Pending Home Care Restrictions passed in 2020 (Lookback, ADL Thresholds)

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/.

This is basic information about Medicaid eligibility for the Disabled, Aged 65+, and Blind (DAB) category and about applying for Community Medicaid in order to receive home care (personal care or consumer-directed personal assistance) through Managed Long Term Care or based on Immediate Need through the local Medicaid program. (updated March 5, 2025 with final 2025 Income and Asset limits released by DOH)

Excel template to calculate Medicaid non-MAGI eligibility under the increased 2025 levels - see http://health.wnylc.com/health/news/90/. Can be used as a tool to estimate spend-down and pooled trust contributions. Template has different tabs for different types of budgeting schemes. -- See list of these at http://health.wnylc.com/health/entry/222/.

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.

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.

Sample notice of intent to discontinue Medicaid, where former SSI recipient failed to return a renewal package to renew Medicaid as a separate stand-alone benefit from SSI. Redacted.

Medicaid program COVID-19 easements

APPENDIX distributed at webinar of Jan. 18, 2023 - UPDATED after webinar with UPDATED HRA Chart of Medicaid Income Levels and UPDATED HRA form MAP-3190 (1/10/23). See further updates of that chart posted at http://health.wnylc.com/health/entry/15/. (Will be updated soon when NYS DOH issues a GIS implemented the 2023 FPL levels. Meanwhile, the 2023 Medicaid levels announced to date were based on the 2022 FPLs.