PowerPoint presented in CLE Webinar on Jan. 18, 2023 by NYLAG Evelyn Frank Legal Resources program on how NYS is rolling out the increases in Medicaid eligibility for the Aged 65+, Blind, & Disabled category (ABD or DAB or NOn-MAGI). Includes how this rollout intersects with "unwinding the Public Health Emergency" starting in March 2023. See updates at http://health.wnylc.com/health/news/90/

NYS Dept. of Health Memo Jan. 13, 2023 with Timeline of Unwinding of Public Health Emergency - when renewals and discontinuances will start, and when the "easements" that loosen documentation requirements for applications will cease and full documentation will be required

NYC HRA Form to notify HRA of corrections or changes, e.g. close case, combine case, add/remove individual, notify of death, change in immigration status, upgrade eligibility, request MSP evaluation, budgeting changes, pooled trust budgeting and add/remove third party health insurance. Per attached 3/2022 memo may be faxed to (917) 639-0837 or mailed. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K. The MAP-751W is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages.

Beginning May 16, 2022, any adult 18 and older seeking fee for service (FFS) Personal Care Services (PCS) and/or Consumer Directed Personal Care Services (CDPAS) for the first time or seeking initial MLTC plan eligibility must be referred to the New York Independent Assessor (NYIA) for their Community Health Assessment (CHA) and Clinical Appointment (CA). This change does not include the Immediate Needs process at this time. NYIA will conduct independent assessments, provide independent practitioner orders, and perform independent reviews of high needs cases for PCS and CDPAS. The NYIA will also take over the work currently done by the Conflict Free Evaluation and Enrollment Center (CFEEC) to assess individuals for MLTC plan eligibility.

Per MICSA Alert dated 03-24-2022, if an older version than the revised DOH 4220 form - Access NY Health Care Application (updated as of 9-2021) is submitted, DOH 5130 (and OHIP-0112) has to be submitted.

This is the statewide DOH-4220 Medicaid Application form used to apply for non-MAGI Medicaid (updated 8/2021 but HRA just announced this change in an Alert dated 03-24-2022).

The statewide DOH-4220 Medicaid Application form used to apply for non-MAGI Medicaid has been updated (dated 8/2021 but HRA just announced this change in this alert). If an applicant submits an older version of the form, the agency will continue to accept it and not require the applicant to complete the newer application form. However, copies of the OHIP-0112 and DOH-5130 would need to be sent with the older application. It has reminder that as of March 1, 2022, the DOH-5178A will be the only Supplement A accepted with the DOH-4220 application.

A Medicaid Recipient who submits medical bills from a Provider to meet the spenddown will receive an OHIP-3183 “Provider/Recipient Letter” indicating which medical expenses are the responsibility of the Recipient (and which the Provider should not bill to Medicaid). When the Recipient is enrolled with a Managed Long Term Care Plan (MLTC), the Recipient and the MLTC will receive an OHIP-0128 “MLTC/Recipient Letter” indicating the amount that the Recipient owes to the MLTC (after deducting the medical expenses/bills from the spenddown). These forms replace the LDSS-3183 form.

HRA did a mass mailing to all recipients requesting them to update their residential or mailing address (as well as alternative format and language preferences). The alert includes Form 751k for recipients to report changes.

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.