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Notice of Acceptance of your Medical Assistance Application/Recertification Download
MAP-259p_redacted.pdf
This is a redacted MAP-259p form to act as a guide for purposes of Medical Assistance application/recertification
13 Apr, 2015 334 kb Downloads: 498
Notice of Renewal of your Public Health Insurance Coverage Download
MAP 2088v_redacted.pdf
This is a redacted notice of renewal of public health insurance coverage to act as a guide to help clients fill out their renewals.
13 Apr, 2015 882 kb Downloads: 217
Formerly Incarcerated Individuals Reactivation Transmittal Download
map-3103 Formerly Incarcerated Individuals Reactivation Transmittal.pdf
This form was uploaded by NYC HRA on 2/20/15 to help formerly incarcerated individuals reactivate their medicaid account once they have been released.
13 Apr, 2015 111 kb Downloads: 377
Notice of Permanent Placement Medicaid Managed Care Download
MAP-2159i Notice of Permanent Placement Medicaid Managed Care.pdf
NYC HRA uploaded this form on 4/3/15 to be used for clients requiring permanent placement under Medicaid's managed care plan.
13 Apr, 2015 36 kb Downloads: 1338
MAGI Consumers Long Term Eligibility Rules Download
2014-10-24 MAGI Consumers Long Term Eligibility Rules.pdf
long term eligibility rules for individuals who are eligible for Medicaid under a Modified Adjusted Gross Income (MAGI) eligibility group
09 Apr, 2015 74 kb Downloads: 1647
8 Helpful hints for accurate completion of the medical request for home care (M11Q) Download
2014-12-09 8 Helpful HInts re Completion M11q.pdf
8 helpful hints for accurate completion of the medical request for home care (M11Q)
09 Apr, 2015 61 kb Downloads: 1263
Consumers Whose Active Medicaid Coverage on the NYSOH (Marketplace) Must be Transitioned to WMS Download
2015-01-05 Consumers transitioned from NYSOH to WMS update (HIV SNP).pdf
Consumers who wish to enroll in an HIV SNP must also have their coverage transitioned to WMS.
09 Apr, 2015 53 kb Downloads: 883
CASA Fact Sheet Download
CASA FAct Sheet 2015.doc
Fact sheet describing what is covered under Housekeeping Services and where CASA offices are located
09 Apr, 2015 30 kb Downloads: 1041
HRA MICSA Alert 2015-03-10 Download
2015-03-10 CORRECTED UPDATE Transition coverage from NYSOH to WMS.pdf
Consumers who have their Medicaid coverage through the New York State of Health (the Marketplace) and who require certain services, must have their case transitioned to WMS (and administered by HRA) in order to receive those services
03 Apr, 2015 145 kb Downloads: 1840
15-03-26 Relocation of HRA Headquarters Download
15-03-26 Relocation of HRA Headquarters.pdf
As of March 2, 2015, the Office of Legal Affairs has moved.

Their new contact information is:

HRA Office of Legal Affairs
ATTN: MICSA LPCU
150 Greenwich Street, 38th Floor
New York, NY 10007
Fax: (917) 639-0331
OLAMAReferrals@hra.nyc.gov
03 Apr, 2015 266 kb Downloads: 2589
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