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Applying For and Keeping Medicaid
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: 5283
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: 3336
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: 5948
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: 4068
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: 51100
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: 18781
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: 26567
HSCP-3047b MLTC Nursing Home Eligibility Determination Cover Sheet Download
HCSP-3047b 1-26-2015.pdf
This is the cover sheet to used for MLTC NHED
13 Apr, 2015 55 kb Downloads: 5120
HCSP-3047a MLTC/PRU Download
HCSP-3047a MLTC-PRU 1-26-15.pdf
This is the MLTC Provider Relations Unit cover sheet to be used
13 Apr, 2015 47 kb Downloads: 3287
MAP-58u List of Medicaid Offices Download
MAP-58u Where To Apply.pdf
This is a list of Medicaid Offices throughout NYC's 5 boroughs, along with a list of MICSA/MAP sites with certified application counselotrs
13 Apr, 2015 377 kb Downloads: 3962
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