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HRA MICSA Alert 8-12-2021 Disability Determination Form LDSS-1151 Replaced with DOH-5139 Download
2021-08-12 Disability Determination Form LDSS-1151 Replaced by DOH-5139.pdf
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
13 Aug, 2021 142 kb Downloads: 2889
Contact List of CASA Offices - Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)
04 Aug, 2021 309 kb Downloads: 35481
2021-7-22 MAP New Home Care Services Program Inquiry Email Address Download
2021-07-22 HCSP inquiries by email.pdf
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.
26 Jul, 2021 129 kb Downloads: 2130
NYLAG Comments on How State Proposes to Implement the "Lookback" for Community -Based Long Term Care Services Download
NYLAG Comments to CMS 5-6-2021 1115 Waiver Lookback.pdf
Comments filed on May 5, 2021 in response to the State Dept. of Health's proposal to CMS on how it will implemenet the 30-month Lookback, that was enacted in the NYS FY 20-21 Budget, and applies to MLTC enrollment and all other home care and the Assisted Living Program. The State's proposal can be viewed at https://health.ny.gov/health_care/medicaid/redesign/mrt2/proposals/30-month_lookback-final.htm
16 May, 2021 820 kb Downloads: 1527
MAP-751K Consumer Request to Change Information on File (3-15-21)(fill-able) Download
MAP-751K (3-15-2021)(English)(fill-able).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 3-15-21). The MAP-751K is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages. Upon completion, it can be faxed to HRA using 917-639-0837. (Updated 2-18-2021) 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.
16 May, 2021 89 kb Downloads: 9135
MAP-751k (Spanish)(3-15-2021) Download
MAP-751K (3-15-2021)(Spanish).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 3-15-2021) NOTE: The 751k is no longer used to request a change in budgeting. Instead use new form MAP-751W available at https://www1.nyc.gov/site/hra/help/health-assistance.page in various languages.
31 Mar, 2021 75 kb Downloads: 1469
HRA MICSA Alert 8-22-2019 Elimination of MAP 2097K - with sample of MAP 909e Renewal Form Download
2019-08-22 Elimination of MAP-2097K- with 909E Renewal Form.pdf
Says MAP-2097K Health Insurance Eligibility Screening Worksheet is obsolete. Alert includes sample of MAP 909E (4/19/18) which is still the renewal form used in NYC as of 3/30/21. Says renewals will be deferred if all pages not submitted. Note that Alert has no date but the HRA MARC website indicates date is 8/22/19.
30 Mar, 2021 324 kb Downloads: 3912
2021-03-26 MICSA Alert IRS Form 1095B Download
2021-03-26 IRS Form 1095B.pdf
IRS Form 1095B will no longer be mailed automatically
30 Mar, 2021 121 kb Downloads: 1747
Fact Sheet on Medicaid Renewals Download
Renewal Fact Sheet 2020 - English (w attachments) FINAL_updated 2-23-21.pdf
Tips for renewing Medicaid in NYC
23 Feb, 2021 2.38 mb Downloads: 5787
Fact Sheet on Medicaid Renewals SPANISH Download
Renewal Fact Sheet - Spanish Version (FINAL w attachments) pdf.pdf
Tips for renewing Medicaid in NYC
21 Jan, 2021 2.24 mb Downloads: 2660
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