Fact Sheet includes key forms (updated 12-2021)

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.

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.

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.

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

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)

updates earlier fax lists - allowing submission of applications and other documents by fax during COVID-19 emergency, and adds some email addresses for inquiries

Announces TWO new forms to request a determination of disability for a pooled trust/ Supplemental Needs Trust, MBI-WPD and other reasons. The Disability Determination Form LDSS-1151is being replaced with DOH-5139 (download at https://www.health.ny.gov/forms/doh-5139.pdf). A new HIIPPA form must also be submitted https://www.health.ny.gov/forms/doh-5173.pdf - along with the OCA form used by the local districts. - https://www.nycourts.gov/forms/Hipaa_fillable.pdf

Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)

This Alert is to advise Medicaid Providers, Hospitals, Client Representatives, Community Based Organizations, Certified Home Health Agencies(CHHA), and Advocates, that the Home Care Services Program (HCSP) has created an email inbox to allow for the submission of inquiries related to HCSP Medicaid case transactions using hcspinquiries@hra.nyc.gov. Allowed inquiries/transaction include demographic changes, address updates, pooled trust review, county-to-county transfer requests, Medicare Savings Program and coverage updates. This email is NOT FOR SUBMITTING APPLICATIONS or documents related to an application. Please read Alert for required information.