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Medicaid
HRA MAP 259d Nursing Home Discharge Alert - for Community Budgeting & Related Forms (10--2015)(with various forms updated as of 8-24-20) Download
MAP-259d-e-f-g-t Discharge Alert and Related Forms (2015-10) updated forms as of 8-24-20 (259f -648p -259t).pdf
NYC MICSA Medicaid Alert with attached forms including "Discharge Alert" 259d that nursing home physician must sign and home must submit to Medicaid to certify that a resident has a reasonable expectation to return home, which entitles resident to community budgeting (non-chronic care) - so they keep entire community Medicaid allowance rather than only $50/month. Form replaces 1159. PDF includes - Form 259f Notice of Discharge revised 2018-07-31 (now includes check-off that resident advised of Special Income Standard for those discharged from NH to MLTC) ; Form 259e (Change/Cancellation of Discharge Plan), 259g (Respite Alert), 259t (updated 5/2020) -- all forms used by nursing homes to inform HRA/MICSA of discharge plan for community budgeting or respite admission. This PDF has updated forms as of 9/23/20 from NYC MARC website.
23 Sep, 2020 1.28 mb Downloads: 64760
MAP-751K Consumer Request to Change Information on File Download
MAP-751K (2-18-2020).pdf
NYC HRA Form to use any time notifying HRA of change or requesting a change in budgeting. Use for requesting Special Income Disregard for Housing, Spousal Impoverishment budgeting, Pooled Trust budgeting, etc. (Form updated 2-18-2020) check for updates here https://www1.nyc.gov/assets/hra/downloads/pdf/services/health/MAP-751K.pdf
22 Sep, 2020 71 kb Downloads: 4022
Medicaid income and resource levels - 2020 Download
2020-03-13 HRA Medicaid Chart.pdf
NYC HRA Form MAPDR-01
2020 NYS Income and Resource Standards and Federal Poverty Levels (FPL)
Dated 3-13-2020
18 Aug, 2020 2.16 mb Downloads: 412819
2020-06-22 NYS Medicaid Program Modifications COVID-19 Emergency Download
2020-06-22 NYS Medicaid program Modifications COVID-19 Emergency.pdf
23 Jun, 2020 253 kb Downloads: 572
2020-05-28 Defective Renewal Notices During COVID-19 Emergency Download
2020-05-28 Defective Renewal Notices.pdf
HRA Alert about notices sent in error to 30,000+ Medicaid recipients in NYC discontinuing Medicaid. The alert has the language of the correction notices that the consumers will receive.
31 May, 2020 78 kb Downloads: 648
2020-05-27 Updated Fax Submissions to MICSA and HCSP Download
2020-05-27 Fax Submissions to MICSA & HCSP.pdf
updates earlier fax lists (5/4/20) - allowing submission of applications and other documents by fax during COVID-19 emergency
29 May, 2020 46 kb Downloads: 881
NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2019 Download
2001_to_2019_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2019. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
19 May, 2020 3.71 mb Downloads: 290210
Using an SNT to eliminate the Medicaid spend-down Download
SNT Short Updated for Garcia v. Banks (VB).pdf
How to get Medicaid despite having "excess income" - Using a Supplemental Needs Trust to Eliminate the Spend-down for Persons who are Elderly (65+), Blind or Disabled. Written by New York Legal Assistance Group (originally from Selfhelp Community Services) updated January 2020
04 May, 2020 1.16 mb Downloads: 142959
2019-12-12 Relocation of Brooklyn CASA Office Download
2019-12-12 Relocation of Brooklyn CASA office.pdf
30 Mar, 2020 96 kb Downloads: 303
MAPDR-21 - Medicaid Managed Care Exemptions and Exclusions Download
MAPDR-21 Medicaid Managed Care Exemptions and Exclusions 9-28-2015.pdf
This documents lists which categories of beneficiaries are exempt or excluded from the requirement of joining a mainstream medicaid managed care plan. Rev'd 9/28/15
03 Jan, 2020 71 kb Downloads: 11002
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