NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC
Applying For and Keeping Medicaid
Statement of NYLAG on 2016 NYS Budget Proposals to Eliminate Spousal Refusal and Reduce Spoual Impoverishment Protections Download
NYLAG Spousal Protections 2016.pdf
Statement of NYLAG on 2016 NYS Budget Proposals to Eliminate Spousal Refusal and Reduce Spoual Impoverishment Protections
04 Feb, 2016 385 kb Downloads: 3726
NYLAG Comments on Proposed State Regulations to Expedite Medicaid and Personal Care for those with Immediate Need Download
NYLAG Comments Immediate Need PCS 12-9-2015.pdf
Comments filed Dec. 9, 2015 in response to proposed state regulations (10-28-2015) to implement 2015 state law changes requiring expedited 7-day approval of Medicaid for those with immediate need for personal care or consumer directed personal assistance.
21 Dec, 2015 191 kb Downloads: 4646
NYC HRA MICSA Form MAP-3069b Request for Agency Conference Download
MAP-3069b 2014-05-01 Request for Agency Conference (Non-Edits and Edits combined).pdf
Form renamed in 2014 - formerly known as Request for Reconsideration. 2 versions of form are in this PDF - One is "Non-EDITs" and one is "EDITS."
25 Sep, 2015 73 kb Downloads: 4745
June 10, 2014 HRA MICSA Alert - Submission of Medicaid Application Reconsideration and Reapplication Requests Download
2014-06-10 Submission Application Reconsideration and Reapp Requests.pdf
Notifies outside submitters of changes to HRA’s process for submitting case reconsideration and reapplication requests. Both processes are being standardized across the Medical Insurance and Community Service Administration’s (MICSA’s) Divisions, with the exception of the Nursing Home Division. The reconsideration process is also being renamed as a
Request for an Agency Conference. MICSA’s Reconsideration Request form (MAP-3069b) has been renamed to “Request for an Agency Conference.” It replaces forms MAP-751, MAP-751a, MAP-751h and MAP-751j which
were previously used by various MICSA divisions to accept requests for case reconsiderations.
25 Sep, 2015 60 kb Downloads: 5715
MICSA - Renewal Status File Download
HRA Presentation to MLTC Plans - Renewal Status File.pdf
Presentation from NYC Human Resources Administration to managed care plans on the NYC process for helping managed care plans work with their members to renew Medicaid coverage. Describes renewal timeline in general, as well as special weekly data file (RS) sent to plans to help them identify members who need follow-up. May 14, 2012.
27 Jul, 2015 171 kb Downloads: 3696
NYC HRA MICSA Alert - Renewal Status Information for Medicaid Recipients (9/21/2012) Download
NYC HRA Medicaid Alert - Renewal Status Information for Medicaid Consumers 9-21-12.pdf
reminder that renewal status information is available for Medicaid clients through HRA’s Medicaid Helpline (888-692-6116). This status is available through an Interactive Voice Response System (IVRS) and is updated daily. By entering a client’s social security number and date of birth into IVRS, the caller can obtain information on the status of a client’s renewal:

Whether or not HRA has received a renewal from the client,
Status of HRA’s processing of the renewal and
The eligibility decision if the renewal has been processed.

The system is being upgraded and will, in the next few months, also allow the option of using case number to receive information.
27 Jul, 2015 56 kb Downloads: 6349
Policy Change for the Start Date of the Transfer of Assets Look Back Period Download
2015-06-02 Policy Change for the Start Date of the Transfer of Assets Look Back Period.pdf
Effectively immediately, the review of assets is limited to the 60-month period immediately preceding the month of institutionalization and application for Medicaid.

For Medicaid recipients who are institutionalized for long-term nursing home care or receiving more than 29 days of rehabilitation services, the look-back period consists of the 60 months preceding the month of institutionalization.
02 Jun, 2015 308 kb Downloads: 4473
Form M-11q - Medical Request for Home Care (12-9-014) Download
HCSP-M11q (12-9-2014)Fill-in-able.2.pdf
This is the form used by the New York City Human Resources Administration for doctors to request personal care services through Medicaid for people who are excluded or exempt from Managed Long Term Care. This means it is for people in the OPWDD, TBI or NHTDW waivers, who require only Housekeeping services of up to 8 hours/week or who are under age 21. The form was updated 12/2014. This is a fillable version. THe original PDF can be downloaded at http://www.nyc.gov/html/hra/downloads/pdf/services/micsa/m_11q.pdf.
21 May, 2015 137 kb Downloads: 51832
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 Download
Appendix Final.pdf
NYLAG Evelyn Frank Program "Appendix" of documents on MLTC and FIDA for CLE 4/20/15 - includes helpful lists of plans, forms, and a Troubleshooting guide.
27 Apr, 2015 2.24 mb Downloads: 19158
Troubleshooting Problems Enrolling in MLTC Plans - Tips for Avoiding Delays and Medicaid Spend-down Problems Download
Troubleshooting - 4-16-15 pp.pdf
Fact sheet written by New York Legal Assistance Group Evelyn Frank Legal Resources Problem addressing common problems encountered by those trying to enroll in MLTC plans, especially where they have a spend-down OR are trying to leave a nursing home. Learn how to avoid delays in enrollment. Includes helpful forms, focused on NYC but can be adapted statewide (updated April 15, 2015)
16 Apr, 2015 2.11 mb Downloads: 27398
Prev Next


This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.