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Applying For and Keeping Medicaid
MAP-751W Consumer/Provider Request to Change Information on File (11-25-2024)(fill-able) Download
MAP-751W Request to Change Information (Doc required) (11-25-2024).pdf
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. may be faxed to Fax 1-917-646-0837 per August 2024 Medicaid Alert http://www.wnylc.com/health/download/738/. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K. The 2018 version of the MAP-751W is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages - but has not yet been updated to the 2024 version as of 1/23/25.
20 Feb, 2025 186 kb Downloads: 10484
MAP-751K Consumer Request to Change Information on File (12-14-2023)(fill-able) Download
MAP-751k consumer-provider request to change info on file (English) (2023-12-14).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 12-14-2023). The MAP-751K is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages. Fax to HRA MAP Undercare 1-917-646-0837 per Medicaid Alert 8/2024 http://www.wnylc.com/health/download/738/. NOTE: The 751k is no longer used to request a change in budgeting. For that, use new form MAP-751W posted at the same webpage as above for the 751K (but updated form not posted there - use http://health.wnylc.com/download/770/
24 Jan, 2025 111 kb Downloads: 10177
MICSA Alert 8-2-2024 Relocation of Brooklyn South (MAIN) Medicaid Office and Authorized Rep Window Download
2024-08-02 Change address for C-Rep and brooklyn_south.pdf
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.
17 Sep, 2024 134 kb Downloads: 759
HRA MICSA Alert 2015-03-10 Download
2015-03-10 CORRECTED UPDATE Transition coverage from NYSOH to WMS with copy of 2014-06 Original Alert + Transmittal form.pdf
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.
31 Oct, 2023 505 kb Downloads: 6196
Stenson - Sample Notice of Discontinuance for Failure to Return Stenson Renewal Download
Disco notice after Stenson packet not received - 2023 Redacted.pdf
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.
27 Mar, 2023 2.25 mb Downloads: 1339
2023-01-25 Medicaid Program Modifications COVID-19 Emergency ENDING Download
2023-01-25 COVID-19 Program Modifications.pdf
Medicaid program COVID-19 easements
29 Jan, 2023 82 kb Downloads: 14201
APPENDIX from NYLAG webinar 1/18/23 on Medicaid Increased Income Limits 2023 (Updated 1/27/23) Download
Medicaid NYLAG CLE Appendix final.revised3 UPDATED.pdf
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.
28 Jan, 2023 3.16 mb Downloads: 2985
Training Powerpoint on 2023 Medicaid Increases in NYS Download
PPT NYLAG CLE Medicaid Increases 2023-01.pdf
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/
25 Jan, 2023 696 kb Downloads: 3141
NYS Dept. of Health Memo Jan. 13, 2023 with Timeline of Unwinding of Public Health Emergency Download
2023-01-13 DOH Unwind Timeline guidance.pdf
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
20 Jan, 2023 357 kb Downloads: 1806
2022-0-5-13 New York Independent Assessor Download
2022-05-13 New York Independent Assessor.pdf
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.
23 May, 2022 93 kb Downloads: 2041
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