Attestation of Resources Expanded to Income for Some Medicaid Recipients - On Renewal and Applications

Since 2004, Medicaid documentation requirements have been simplified by allowing some applicants merely to "attest" rather than document certain eligibility factors.  In that year, attestation to the amount of one's resources was first allowed for Medicaid applicants who were not seeking Medicaid long-term care services(including home care and other community-based long-term care services) and for applicants for Medicare Savings Programs. 

• LAW:   Section 366-a(2) of the Social Services Law, enacted by Chapter 1 of the Laws of 2002, 
• Implementation directives:  04ADM-06 - Attestation of Resources  (as updated by 2010 changes),   05/OMM-INF - 2 June 8, 2005

• This HRA chart, explains the different types of documentation required of an applicant's resources (aka "assets") for the three different levels of coverage provided by New York State's Medicaid program.  It also explains which services are covered for each of the three levels. 

In 2008, all resource limits were repealed for the Medicare Savings Programs. 

Effective January 1, 2010,  resource limits were repealed for all Medicaid recipients except those in the Aged 65+, Disabled, Blind category (DAB or "SSI-Related").  Therefore, "attestation" remained an option for those Medicaid recipients who are  age 65+, blind, or disabled but who do NOT NEED long-term care services in the community or in the nursing home.  If they are only seeking the other community-based services, they may "attest" to their resources.  If, later, they need any of the long-term care services, they must verify resources.  

• The State Department of Health issued policy guidance to local districts in detailing the implementation of resource attestation for those not seeking long-term care in the community.  SEE:

  • GIS 09/MA027 - Elimination of Resource Test for Non-SSI Related Medicaid Applicants/Recipients   (Nov. 2009)

  • NYS DOH 2010-ADM-01 (January 2010).

Effective for renewals received on or after March 1, 2011 -- SSI-related  (Disabled, Age 65+, or Blind = "DAB") individuals who are in receipt of Community Coverage with Community–Based Long-Term Care :

• will be allowed to attest to income, resources and a change in residency at the time of renewal. These individuals will continue to be required to document income and resources at the time of initial application and when applying for Medicaid to pay for nursing home care.  SSI-related individuals will also be required to document income and resources when a change in coverage is required in the community (e.g., moving from Community Coverage without Community-Based Long-Term Care to Community Coverage with Community-Based Long-Term Care).

Effective for applications filed on or after March 1, 2011 --  All FHPlus applicants, and  those Medicaid applicants with no resource test (those who are under age 65, not disabled or blind) --

•  can attest to their interest income. If based oninformation available to the district, the amount of reported interest income is questionable and the inconsistent amount could affect eligibility for Medicaid benefits, the applicant may be required to provide follow-up documentation to determine eligibility, as described in Section IV. B. of this ADM. Currently, at renewal, FHPlus and non-SSI-related Medicaid  recipients may attest to their income, including interest income, and a third party database is used to validate the information.

2011 Changes described above in 11-ADM-01 - Expansion of Attestation of Income, Resources and Residence at Renewal,and Attestation of Interest Income at Application for Family Health Plus and Certain Medicaid Applicants (March 11, 2011).

• HRA Alert Implementing Changes  (May 3, 2011)

This article was authored by the Evelyn Frank Legal Resources Program of Selfhelp Community Services, Inc.