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2021-12-28 Usage of DOH 5178A Medicaid Application Supplement and DOH 4495A
2021-12-28 Usage of DOH5178A Medicaid App Suppl & DOH 4495A.pdf
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.
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11 Jan, 2022
77 kb
Downloads: 1959
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HRA Medicaid Alert - Requesting Report Changes in Address during Pandemic
2021-12-20 MAP Request for Information form 751v + 751k.pdf
Announces mass mailing to all NYC Medicaid recipients asking them to report any address changes and certain other changes that occurred during the pandemic with Form 751K. Updating addresses is important because once the pandemic is declared over, all recipients will receive Renewal notices by mail. Without an updated address, they will not receive these renewals, and Medicaid could be discontinued. Form 751-k can be downloaded at http://www.wnylc.com/health/download/638/ (fillable) or in varioius languages at https://www1.nyc.gov/site/hra/help/health-assistance.page.
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22 Dec, 2021
1.46 mb
Downloads: 1804
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Form DOH-5143 - Medical Disability Form - replaces LDSS-486T (08-2018)
DOH-5143 Replaces 486T Medical Report for Determination of Disability (08-2018) - FILLABLE.pdf
Form to be signed by treating physician to certify disability as required for approval of Supplemental Needs Trusts, or for Medicaid based on disability where the Social Security Administration has not determined disability. Replaces Form 486T. See HRA MICSA Alert Dec. 20, 2021, available at http://www.wnylc.com/health/fdownload/799/
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22 Dec, 2021
50 kb
Downloads: 5826
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HRA Medicaid Alert 12/20/21 - New Form DOH-5143 Replaces Form 486T for Medical Determination of Disability
2021-12-20 Medical Disability Form LDSS-486T Replaced with DOH-5143.pdf
Announces a change in the form for treating physician to certify disability as needed to approve supplemental needs trusts including pooled trusts, and Medicaid based on disability, if not certified by the SSA. Replaces Form 486T, though 486T will be accepted until Feb. 1, 2022. New form posted at http://www.wnylc.com/health/download/798/
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22 Dec, 2021
718 kb
Downloads: 2873
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NYLAG Fact Sheet on Applying for Medicaid and Home Care if "Immediate Need" for Personal Care or Consumer-Directed Services
Fact Sheet Immediate Need (2021-12-3) Complete.pdf
Fact Sheet includes key forms (updated 12-2021)
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03 Dec, 2021
925 kb
Downloads: 15793
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NYLAG PowerPoint on 2021-22 Medicaid Home Care Changes & Lookback
NYLAG Budget PowerPoint Home care changes 10-2021.pdf
Powerpoint with latest info - as of Oct. 20, 2021 -- on implementation of changes enacted in the NYS FY 2020-2021 budget, including the restrictions on eligibility for Personal Care services (PCS) and CDPAP services (reqiring 2-3 ADLs), the Independent Assessor procedures, and the loosened standards allowing plans to more easily reduce hours of home care after a "transition period" for certain members.
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20 Oct, 2021
1.31 mb
Downloads: 1998
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Transitioning of MAGI-like Medicaid Cases from DSS/HRA Medicaid to NYSOH
2021-09-27 Transitioning of MAGI - Like Medicaid Cases.pdf
Since the New York State of Health was introduced in 2014, it has been responsible for all MAGI Medicaid cases. However, there were many Medicaid consumers with MAGI-like budgeting who were found eligible before January 1st, 2014. Their cases have remained with HRA until they could be transitioned. Those consumers were to be transitioned in phases and the first transition began in June 2018. NYS has resumed the transition and approx. 158,600 individuals transitioned between April 2021 through July 2021. The alert details which groups of MAGI recipients were transitioned and those who will not be transitioned. Clients will not be required to renew their coverage in NYSOH until after the COVID-19 Health Emergency ends.
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06 Oct, 2021
213 kb
Downloads: 3716
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Reopening of Chinatown Medicaid Office
2021-09-22 Reopening of Chinatown Medicaid Office.pdf
Chinatown Medicaid Office reopened at the same location (115 Chrystie St., 5th Fl., New York, NY 10002; tel. (212) 334-6114). Open 9:00am to 5:00pm, Monday thru Friday.
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06 Oct, 2021
78 kb
Downloads: 1516
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2021-9-08 MAP Undercare Division - Case Action Update Requests via Email
2021-09-08 MAP Undercare Division email REVISED +751k -751w forms.pdf
This Alert is to advise Medicaid Providers, Hospitals, Client Representatives, Community Based Organizations and Advocates that the Medical Assistance Program's Undercare Division can now receive case action update requests via email at undercareproviderrelations@hra.nyc.gov. This email is NOT FOR NEW APPLICATIONS. MAP 751k or 751w form attached to this alert is required. This alert revises the July 2021 alert
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12 Sep, 2021
539 kb
Downloads: 3627
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HRA Medicaid alert 2020-05-27 Authorized Client Representatives - COVID-19 Application Submissions by E-fax
2020-05-27 Fax Submissions to MICSA & HCSP.pdf
Updates alert from April 2020 with additional e-fax numbers.. Establishes new e-Fax number for "C-Rep" Authorized client Representatives for Medicaid applications not submitted electronically by EDITS. e-Fax 917-639-0731.
Requests ONE application be submitted per fax, with cover page listing all documents attached. Says not for MLTC application submissions (unclear what this means)
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04 Sep, 2021
46 kb
Downloads: 2528
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