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.

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

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.

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.