Covid-19 Resources and Advocacy on Medicaid in NYS - COVID Flexibilities extended through Oct. 2020

As Social Distancing and  shuttered offices become the new normal, New Yorkers who depend on Medicaid or need to apply for it need to learn new policies and  procedures that are quickly being developed by the federal government (CMS),  the NYS Department of Health (DOH), and by each local Medicaid agency, which in New York City is HRA.   On this page we will gather links to helpful resources and to key government guidance, as well as describe advocacy done by NYLAG, Legal Aid Society, Empire Justice Center, Bronx Legal Services, and other organizations regarding Medicaid. 

NYLAG consumer-friendly guide to many Covid-19 changes in  benefits                                                       https://www.nylag.org/covid19/ -- 

Information on Housing, benefits,  employment & unemployment, courts, taxes, powers of attorney, and many other benefits.   For HEALTH, click on  Medicaid (Applying), Medicaid (Home Care), Medicaid (If you Already Have), or Medicare.

In This Article:

1. NEWS UPDATES  

2. NYS OTDA Fair Hearing Information

3. Medicaid Home Care - NYS Dept. of Health Policies and Procedures & Consumer Advocacy

4. Medicaid  Applications, Renewals, Eligibility in NYS - and Consumer Advocacy

   • 3a.  NYS and NYC Directives on Medicaid applications, procedures, etc.

   • 3b.  NO MEDICAID CASE CLOSINGS/ Automatic Renewals

   • 3c.  Applications

5. Emergency Medicaid for Undocumented Immigrants - Covers Covid-19 Testing & Treatment 

6. How do Covid-19 Federal Stimulus Payments impact SSI, Medicaid & other Benefits - including for Nursing Home & Adult Home Residents?

7. Federal Authorities Allowing States flexibility in Disasters + NYS Request for  1135 Waiver

8. NYS Dept. of Health Guidance for Health Care Providers

   • ​​​​​​Home Care, private duty nursing
   • Adult Day Care
   • Nursing Homes & Adult Care facilities (Assisted Living, adult homes, ALP) 

9. Compilations of Resources from National & NYS Organizations

1.  NEWS UPDATES

• October 2, 2020 - HHS Secretary Azar  Extended the Public Health Emergency effective Oct. 23, 2020.  This is the 34d extension.  The extensions are for 3 months, so it will expire Jan.. 23, 2021 unless renewed again. As a result of this extension, all of the flexibilities described for applications and renewals and the ban on discontinunces extend through January 2021.  

• Sept. 15 and 17, 2020 - CMS and DOH Open Nursing Home Visitation --  Limited Visitation Permitted for Facilities Without COVID-19 for at Least 14 Days  (NYS 9/15/20), which NYS DOH issued just before CMS also issued guidance opening up visitation in nursing homes. Nursing Home Visitation - COVID-19 (CMS, 9/17/20)

• OTDA Phone Hearing Demonstration Extended to March 12, 2021  (July 17, 2021)

• July 10th - limited visitation allowed in Nursing Homes, other congregate facilities - See here.

• New June 12, 2020 - DOH posts Guidance for Nursing Home and Adult Home Administrators that residents are entitled to keep the stimulus payment.   See more here. 

• May 20, 2020 NYS DOH POSTS FACT SHEETS FOR CONSUMERS on DOH website and  NYSofHealth websites

• Medicaid Coverage through Your Local Dept. of Social Services (LDSS) during the Coronavirus Emergency: English - (PDF)  (Discussed further below  - Medicaid Applications and Keeping Medicaid)

• Medicaid Telehealth Services During the Coronavirus Emergency - May 2020 - English -(PDF)

• NYSofHealth:  Fast Facts on NYS of Health Insurance Options During COVID Emergency - English (PDF)

• NYSofHealth:  Q&A on Grace Period & Special Enrollment Period for COVID-19  (PDF)

•  NEW  - May 18, 2020 -NYLAG Know Your Rights Fact Sheet for MLTC Members about April 23, 2020 DOH Guidance on Voluntary Service Plan Changes in MLTC, FFS Home Care  -

  • What are members' rights  to "pause" home care during the emergency?

  • What are member's rights if plan tells member hours must be reduced because of Covid-19?

• New -  NYS Dept. of Health updates Deaths in Nursing Homes from COVID - by NH  (updated frequently)

 2.   NYS Medicaid FAIR HEARINGS - Office of Temporary  & Disability Assistance

• Demonstration Phone Hearing program  - holding all hearings by phone 

  • OTDA GIS 3/12/2020  Office of Administrative Hearings Transmittal 20-02; 20 TA/DC014 – Hearings by Phone - Initial date of demonstration is from March 12 to Sept. 12, 2020.  

  • FAQ - April 16, 2020 -  OTDA OAH Transittal 2020-03 - Frequently Asked Questions about Phone Hearings 

  • PHONE HEARING DEMO EXTENDED TO March 12, 2021 -GIS 20 TA/DC-076:  “Allowing or Requiring Fair Hearing Appearances by Written, Telephonic, Video, or Other Electronic Means"  (July 17, 2020)

• ADVOCACY:    Letter to OTDA 3/24/20 Requesting Clarification of GIS above and for protections for appellants in the new phone hearing procedures - from NYLAG, Legal Aid Society, Empire Justice Center & other organizations. 

• Submitting documents for telephone hearing - Appellants or their representative may email documents in advance of the hearing to  otda.sm.fhdocuments.submissions@otda.ny.gov --OTDA said this email address may only be used during the Covid-19 emergency. 

  • Or use same FAX used for requesting fair hearings.. FAX 518-473-6735

 3.  Medicaid Home Care - NYS Dept. of Health

DOH is issuing frequent guidance to Medicaid providers here and  to all health care providers at this ink. 

See below for some key provider directives from DOH.  

Here is some of the key home care guidance relevant for consumer Medicaid advocates:

• April 8, 2020 updating Mar. 18, 2020 -  COVID-19 Guidance for the Authorization of Community Based Long-Term Services and Supports Covered by Medicaid – UPDATED 4.8.20 

  • For Medicaid Managed care and MLTC plans, local Medicaid agencies, CDPAP agencies

  • Allows physician to complete M11q/Physician's order by telehealth or telephone, without an in-person visit.  4/8/20 update allows MD to CALL in order and follow up with written orders within 120 days.  Plan or DSS can authorize 90-day temporary service plan based on oral orders 

  • Allows the UAS nurse assessment to be completed by telehealth or telephone (by MLTC plans and local Medicaid agencies), except that the conflict-free assessment by NY Medicaid Choice must be completed in person (at least for the functional assessment).  If NY Medicaid Choice cannot do the assessment in person, "the member’s LDSS (local Medicaid office) will develop and monitor the plan of care."  Unclear what that means.

  • Suspends requirement for 6-month periodic re-assessments by nurses for managed care, MLTC and local Medicaid offices.  4/8/20 update also suspends requirement for M11q/physician's order for reassessments for personal care and CDPAP - however, services will only be reauthorized for 3 months, which will create burdens down the road.. 

  • CDPAP personal assistants do not have to obtain the annual health reassessment, but new personal assistants must still have them  (TB test, immunizations)

  • UAS Nurse Assessments in Nursing Homes- it's up to the nursing home to decide whether the assessment is "medically necessary," so nursing home is apparently allowed to refuse access.  This would be conflict-free assessments by NY Medicaid Choice or Immediate Need assessments by the local Medicaid office/CASA.  

•  April 10, 2020  NYS DOH Dear Administrator Letter (see here) to CHHAs, LHCSAs, LTHHCPs, and Hospice programs, the state Department of Health has suspended or changed the following regulations.

  • The annual health assessment has been temporarily suspended for all employees.

  • New employees may have health assessments completed by telehealth or by an RN. New employees must follow guidelines in place for all staff, including daily symptom screenings and at least daily temperature checks.

  • All CHHAs, LTHHCPs, AIDS home care programs and LHCSAs serving individuals affected by the COVID-19 public health emergency may conduct in-home and in-person supervision through indirect means, including by telephone or video communication, as soon as is practicable after the initial visit.

• April 23, 2020  COVID-19 Guidance for Voluntary Plan of Care Schedule Change - (Web)  (PDF) - 
  • Allows voluntary changes in service plans, presumably mostly reductions in hours of home care, on a temporary basis because of the pandemic.  Plan must confirm the change in writing and have the consumer sign agreement.  Plan must reinstate original service plan on 72 hours request.  Advocacy concern exists allowing plan to reach out to consumers to ask for consent to a voluntary change-- this outreach is supposed to be limited to those consumers who have "refused or cancelled services because of concerns about COVID-19 exposure," or who are known to have available informal caregivers, but will consumers be pressured to agree to temporary reductions?    See FACT SHEET for CONSUMERS - KNOW YOUR RIGHTS!
  • This guidance does not expressly prohibit but should prevent plans from disenrolling members who have refused or cancelled services because of COVID. 

    • May 18, 2020 -NYLAG Know Your Rights Fact Sheet for MLTC Members about April 23, 2020 DOH Guidance on Voluntary Service Plan Changes  -covers 

    • What are members' rights  to "pause" home care during the emergency?
    • What are member's rights if plan tells member hours must be reduced because of Covid-19?

ADVOCACY:

• Letter to DOH 3/13/20 supplemented 3/16/20 - from NYLAG, Legal Aid Society, Empire Justice Center  and other organizations 

• Letter to DOH 4/1/20 requesting protections for MLTC members and other long term care recipients from NYLAG, Empire Justice Center & Bronx Legal Services

4. Medicaid Applications, Renewals, Eligibility Determinations

Under Families First Coronavirus Response Act signed on March 18, 2020, no Medicaid recipient will lose their coverage after March 18, 2020 through the end of the Public Health Emergency.  The Public Health Emergency originally ended April 27, 2020.  After an initial extension ending July 26, 2020,  extended until Oct. 23, 2020,  HHS Secretary Azar  extended the Public Health Emergency again effective Oct. 23, 2020.    The extensions are for 3 months, so it will expire Jan. 23, 2021 unless renewed again. As a result of this extension, all of the flexibilities described for applications and renewals and the ban on discontinunces extend through January 2021.   

The National Health Law Program fact sheet, available here, summarizing the Medicaid-related provisions that were included in the three coronavirus response laws enacted so far.

4a.  STATE and NYC POLICIES:

NYS Directives

• NYS Dept. of Health - May 20, 2020  Medicaid Coverage through Your Local Department of Social Services (LDSS) during the Coronavirus Emergency: English - (PDF)  

• NYS Dept. of Health - April 2, 2020  GIS 20 MA/04 – Coronavirus (COVID-19) – Medicaid Eligibility Processes During Emergency Period

• NYS Dept. of Health - March 21, 2020   Covid 19 Guidance on Medicaid Eligibility & Enrollment 

New York City Directives

• NYC HRA 05/27/2020  REVISED Fax Submissions to MICSA & HCSP (revises 4/16/20 & 5/4/20 alerts) 

• NYC HRA 5/28/2020  Defective Renewal Notices During Covid-19 Emergency  (See this update re HRA sending 32,056 case closing notices in error for renewals due May 2020). 

• NYC HRA 9/09/2020 New York State Medicaid Program Modifications COVID-19 Emergency (update to 3/27/20, 6/22/20, & 8/10/20 alert)

4b. AUTOMATIC RENEWALS/ NO DISCONTINUANCES After March 18, 2020  

If Medicaid was authorized for a period ending March 31, 2020 or later,  the local district must recertify  Medicaid  for 12 months, regardless of whether the recipient  fails to return renewals or respond to requests for information - Medicaid will NOT BE DISCONTINUED.  DOH explains this will allow districts to devote the reduced staff to new applications rather than routine renewals.  

• Under GIS 20 MA/04, "Medicaid cases are being extended and individuals will not be required
  to renew their Medicaid eligibility during the emergency period. All active Medicaid cases with
  authorization and coverage dates ending in March, April, May and June will be systemically
  extended for 12 months."  If a case was closed after March 18, 2020 it will be reopened. 

  • 6/22/20 NYC HRA Alert: Cases with coverage dates ending in July and August will also be systematically extended for 12 months

  • 8/10/20 NYC HRA Alert: Cases with authorizations ending in September or October 2020 will automatically be extended for 12 months.  This extension is due to HHS extension of the public health emergency on July 25, 2020, which is generally for 3 months. 

  • 9/9/20 NYC HRA Alert: Cases with authorizations ending in November 2020 will automatically be extended for 12 months. 

  • MAY 28, 2020 - NYC HRA issues an ALERT that it mistakenly notified 32,052 individuals that Medicaid or MSP would be discontinued because of not sending renewals due  in May 2020.  See info here.  

  • Given the Oct. 2, 2020 HHS extension of the Public Health Emergency, for 3 months, we expect that the State will extend the automatic renewals and ban on discontinuances through January 2021. 

• Those who lose SSI or public assistance,  who would normally need to recertify for Medicaid under the Stenson and Rosenberg processes, will have  Medicaid automatically extended for 12 months.  

• Those who had MAGI Medicaid and turn 65, whose Medicaid would normally be transferred from NYSofHealth to the local district, to be redetermined under non-MAGI Medicaid rules - will  have Medicaid automatically extended for 12 months.   Since March  19th, these cases stopped being referred from  NYSofHealth to the local district - coverage was just extended.  They will not have to show that they applied for Medicare, or applied for VA benefits  if they are veterans, contrary to the usual rule.  Some cases may still be referred manually to the LDSS, such as those who need nursing home care, since institutional Medicaid can only be authorized by the LDSS even if eligibility is based on MAGI.  

• "Individuals in the Medicaid Buy-In Program for Working People with Disabilities who have
  experienced job loss as a result of the COVID-19 emergency must be given a grace period
  due to loss of work. If applicable, the grace period should be extended for six (6) additional
  months."  GIS 20 MA/04  The DOH 5/20/20 FAQ clarifies that the initial extension is 6 months, and "an additional six-month period will be provided if needed to look for new employment."  (FAQ #16).

• Medicaid may not be discontinued for "whereabouts unknown" if correspondence from the LDSS/HRA is returned.  GIS 20 MA/04 p. 3

• If had active Medicaid because of "Aid Continuing" on March 18, 2020, this must continue GIS 20 MA/04 p. 6.    The May 20, 2020 DOH FAQ clarifies that  "your Medicaid coverage will continue under Aid to Continue status even if you lose your fair hearing."  (FAQ #7)

Surplus/Spend-down Cases -- If the spend-down was met in March, the LDSS/HRA will put up coverage for 6 months.  NYC Recipients who have problems submitting bills should follow the instructions on the HRA  policy  - and elsewhere contact their local district office. A spend-down may be reduced, but not increased, during the emergency (GIS 20 MA/04)  The May 20, 2020 DOH FAQ states further regarding spend-down, in FAQ #10:

10. I participate in the Medicaid Excess-Income or Pay-In program, but I have been unable to submit a bill or payment due to the COVID-19 emergency. What should I do?

• Contact your local district or, if you pay your spenddown to a Managed Long Term your Care Plan, contact your plan, as soon as possible. Explain that you haven´t been able to submit your bills or pay your spenddown due to the COVID-19 emergency.
• Save your receipts or the monthly amounts of your pay-in (spenddown) because you may be asked to provide them at the end of the COVID-19 emergency period.

4.c. APPLICATIONS

• Allows self-attestation of income, assets and most other factors of eligibility on applications, renewals and requests for increased coverage, except for documenting citizenship and immigrant status on applications. 

  • This is a change from  usual rules - some attestation is generally allowed, but to be eligible for home care and other community-based long term care, one normally must DOCUMENT assets, not self-attest.  See When Documentation of Resources and Income is Required for Medicaid Applications & Renewals - and When is "Attestation" Enough?

  • Transfers of assets and asset eligibility on nursing home applications - may attest.  GIS 20 MA/04 p. 3

  • May attest re Retirement accounts and annuities, but DOH FAQ says, "however you may be required to provide proof at renewal."

• MAY NOT ATTEST TO these - need to submit documentation ( per DOH FAQ May 20, 2020) - Q. 11, 

  • Citizenship and Immigration Status - GIS 20 MA/04 p. 3 - DSS/HRA will try to verify status through SSA data match.  If that can't be done and documentation is needed, DSS/HRA will put up 90 days of coverage while applicant has an opportunity to obtain documentation.   If the emergency period has not ended after 90 days, it will be extended for another 90 days if applicant still hasn't obtained documentation.  See 10 OHIP ADM-8 for procedures "to give a reasonable opportunity period to consumers who are attesting to be U.S. Citizens."

  • Pre-Paid Burial Agreements -   must submit proof that the agreement is final and irrevocable.

  • Trusts - including Pooled Income Trusts - Copies of all trust documents are still required.  Regarding the disability documents for SNT, the DOH FAQ #4 says:

4. I am over 65 and need a disability determination so that I can apply for Medicaid using a pooled trust. I cannot get an appointment with my doctor to complete, sign, and date the NYS disability papers because of the COVID-19 emergency. What can I do?

You should first contact your local district and file your Medicaid application. Your local district staff and Department of Health staff can then help you with the necessary paperwork to process your disability determination. They can also help if you are under age 65 and need a disability determination for Medicaid.

Comment:  How would LDSS or DOH help with the paperwork?

• Individuals turning 65 do not have to apply for Medicare, SSA or VA benefits as a condition of eligibility

• Do not have to respond to reports received by local DSS after  3/1/20 -- that a Social Security number could  not be verified, or that a resource appeared on an electronic match or could not be verified

• No proof of Third Party coverage is required - local districts are not required to make
  new cost effective determinations for possible reimbursement if sufficient information
  is not available.   But if insurance ends, district may stop payment of premium.  GIS 20 MA/04 p.6

• WHERE TO APPLY - Every local DSS has its own procedures.

  • HRA informed advocates that all Medicaid & Medicare Savings Program applications for people who are age 65+ or who are disabled and have Medicare, so cannot apply on NYSofHealth  - can

    • E-FAX applications to 917-639-0732  (HRA PREFERS this to mailing! 

• IMMEDIATE NEED HOME CARE applications should still be filed by E-FAX to 1-917-639-0665. DO NOT fax other applications here. 

• MAIL  to: (HRA prefers use E-FAX number above)

•  NYC HRA  4/6/2020     Authorized Client Representative "C-Rep" Fax Submissions - "Authorized Submitters" ("C-Reps') and providers who have been authorized by HRA to submit applications have been given dedicated fax lines - see

• NYC HRA 5/272020   Fax Submissions to MICSA (Medicaid) & Home Care Services Program (revised) - general fax numbers for applying

• Application Signatures – from GIS 20 MA/04 p.4- 5: and also see 5/20/2020 DOH Consumer FAQ (#2)
  • "During this period, for individuals in hospitals or nursing homes, the Access NY application (DOH-4220-I) and/or Supplement A (DOH-5178A) can be signed by someone acting on the individual’s behalf .

  • If a signature on the application cannot be obtained from the applicant/recipient (A/R) or the A/R’s spouse, Attachment 1  to  17ADM-02 - Asset Verification System , “Submission of Application on Behalf of Applicant” DOH-5147 (MAP-3044 for NYC A/Rs), must be signed by the person signing and submitting the application and must accompany the application. In Section C of the DOH-5147 (Reason for Submission/Section II of the MAP-3044) “COVID-19” should be noted if the A/R cannot sign the form due to access issues. All information must be completed on the application.

  • If a signature can be obtained from the applicant/recipient, Section D (Authorization to Apply for Medicaid on Applicant’s Behalf) of the DOH-5147 form should be signed by the A/R authorizing another person or the facility to apply on behalf of the individual.

• Aged, Blind and Disabled (ABD) Facilitated Enrollers (FE  outside NYC) (in NYC) who are unable to assist individuals in person during this time will be following a similar process with one exception: the DOH-5147 form (or MAP-3044  form) will be signed by the applicant authorizing the ABD. 

 from GIS 20 MA/04 p.4- 5  and see  DOH FAQ #2 

• Requests for Information while Application pending - from GIS 20 MA/04 p. 5

... During this period, if an application or
Supplement A is missing required information, the district should contact the applicant,
authorized representative or the person submitting the application on behalf of the applicant,
if applicable, by email or telephone to obtain the necessary information. The district does not
need to receive the information in writing and can accept information verbally. The eligibility
staff should note in the case record any information obtained by phone and make a notation
in the case record that information was received verbally due to COVID-19 circumstances.

If after three (3) attempts, the local district is unable to contact the individual, the individual’s
authorized representative or the person who submitted the application on behalf of the
applicant (including when no response is received from an email contact), the local district
must send a written request to the individual and the authorized representative or person
submitting the application on behalf of the applicant, for the missing information. The request
sent must include a response due date of no less than 10 days. Information concerning how
the missing information can be given to the district by telephone and/or email must be
included in the letter sent requesting the information.

The DOH FAQ 5/20/20, states,  "If you don´t provide the missing information your application may be denied." (FAQ #3). 

• MSP/Medicare Insurance Payment Program/ Health Insurance Premium Payment program -  “the department can assist districts, if needed, with an extension of MIPP (Medicare reimbursements) and HIPP (health insurance reimbursements) payments to coincide with the extension of an individual’s authorization period.” 

5. Emergency Medicaid for Undocumented Immigrants - Covers Covid-19 Testing & Treatment 

“Emergency Services Only” Coverage - Medicaid Update Number 7: March 2020 Special Edition -
COVID-19 Coverage and Reimbursement Policy (published: 3/27/2020) (Web) or (PDF) — (Redline PDF).

NYS Medicaid coverage for undocumented immigrants is limited to emergency services only. COVID­19 lab testing, evaluation, and treatment are emergency services and will be reimbursed by NYS Medicaid for individuals with coverage code “07.” Claims submitted for COVID-19 tests and practitioner office visits for the purpose of COVID-19 testing, evaluation, and/or treatment should be identified as an emergency by reporting Emergency Indicator = Y.

Institutional providers (emergency department, hospital outpatient/diagnostic and treatment center, FQHC, and hospital inpatient) should report Type of Admission Code = 1 to indicate an emergency when the purpose of the visit is for testing, evaluation, and/or treatment related to COVID-19.

There is no copay for emergency services including testing, evaluation, and treatment for COVID-19.

6.  How do Covid-19 Federal Payments impact SSI, Medicaid & other Benefits?

• Cornell Institute on Employment & Disability Fact Sheet

• See NEWS about FTC BLOG telling Nursing Homes, adult homes and other facilities to KEEP THEIR HANDS OFF of the stimulus payments.

• NYS DOH GIS 20 MA/05 – Impact of the Coronavirus Aid, Relief and Economic Security (CARES) Act on Medicaid Financial Eligibility (PDF)

• ADVOCACY:   PROTECTION OF STIMULUS PAYMENT FOR NURSING HOME & ADULT HOME RESIDENTS --

  • JUNE 12, 2020 - DOH ISSUED Dear Administrator Letter to Adult Care Facilties   reminding facilities that the payment belongs to the resident.  This directive is long overdue - advocates have sought it for two months. 

  •    April 13, 2020 - NYLAG, MFJ, & NYAIL, joined by 14 other organizations, wrote to the NYS Dept. of Health requesting  a directive to Nursing Home & Adult Home operators to ensure that the stimulus payments are protected for residents.  

• • When the Social Security Administration announced on April 15th that SSI recipients would receive their payments automatically by direct deposit, the advocates sent a PS to DOH emphasizing the need for this guidance to protect SSI recipients.

  • On May 18, 2020 - the advocates followed up again, after the FTC issued a blog on May 15th telling nursing home operators to keep their hands off the stimulus payments.  Read more here. 

Click on https://www.nylag.org/covid19/ and go to Economic Stimulus Payments

7.  Federal Authorities Allowing States Flexibility in Disasters - and New York Application to CMS 

• July 25, 2020 extension of Public Health emergency by HHS. Secretary Azar (Extension is generally or 3 months so will expire Oct. 25, 2020 unless extended again)

• CMS Disaster Response Toolkit

• CMS Covid-19 Resource Page

• New COVID-19 FAQs for State Medicaid and CHIP Agencies (PDF)  (FAQs contained in this document are available in the COVID-19 FAQs for State Medicaid and CHIP Agencies (PDF)  (Posted 5/5/2020)

• COVID-19 FAQs on implementation of Section 6008 of the Families First Coronavirus Response Act (Section 6008 is the Maintenance of effort provision which prohibits a state from receiving the enhanced Federal match (FMAP) if they make standards, methodologies or procedures more restrictive than those in effect on Jan. 1, 2020) (April 13, 2020)

• NYS Medicaid 1135 Waiver Request to CMS - (March 23, 2020) NYS DOH seeks waiver of certain requirements for Medicaid eligibility and services, under the 1135 waiver applicable to disasters 

  • CMS waiver approval for NYS  March. 26, 2020 Section 1135 Waiver Flexibilities - New York Coronavirus Disease 2019

  • See other states here

• NHELP Fact Sheet on the Federal Covid-19 laws - CARES ACT and Families First Coronavirus Response Act

• NYS Medicaid Redesign Team (MRT) Waiver COVID-19 1115-a Demonstration Request:
  • Letter (Web) - Application (PDF) - 5.11.2020

8. Selected NYS DOH Guidance for Health Care Providers - of Interest to Advocates

These are just a few of the many guidance documents issued nearly every day - check

GUIDANCE FOR MEDICAID PROVIDERS - https://health.ny.gov/health_care/medicaid/covid19/index.htm

GUIDANCE FOR ALL HEALTH CARE https://coronavirus.health.ny.gov/information-healthcare-providers 

TELEHEALTH  -NYSDOH has issued a “broad expansion for the ability of all Medicaid providers in all situations to use a wide variety of communication methods to deliver services remotely.”   

• Medicaid Update Special Edition: Comprehensive Telehealth Guidance (Web) or (PDF) (published: 5/1/2020).
  • Frequently Asked Questions (FAQs) on Medicaid Telehealth Guidance during the Coronavirus Disease 2019 (COVID-19) State of Emergency - (Web) - (PDF) - Updated 5.1.2020
  • Webinar: New York State Medicaid Guidance Regarding Telehealth, Including Telephonic, Services During the COVID-19 Emergency - 5.5.2020
    • Slides           Recording

HOME CARE, WAIVER PROGRAMS, PRIVATE DUTY NURSING, DME

• Home Care Association of NYS - Covid-19 Resource Page

•  April 10, 2020  NYS DOH Dear Administrator Letter (see here) to CHHAs, LHCSAs, LTHHCPs, and Hospice programs, the state Department of Health has suspended or changed the following regulations.

  The annual health assessment has been temporarily suspended for all employees.

New employees may have health assessments completed by telehealth or by an RN. New employees must follow guidelines in place for all staff, including daily symptom screenings and at least daily temperature checks.

All CHHAs, LTHHCPs, AIDS home care programs and LHCSAs serving individuals affected by the COVID-19 public health emergency may conduct in-home and in-person supervision through indirect means, including by telephone or video communication, as soon as is practicable after the initial visit.

• COVID-19 Guidance for Home Health Care Agencies and Hospice Providers (March 22, 2020)(DHCBS DAL: 20-08 Updated  (replaces version issued 3/14/20)

• Interim Guidance for Home Care Services Regarding COVID-19 (Mar. 16, 2020)

• Nursing Home Transition & Diversion Waiver & TBI Waiver (Mar. 20, 2020)(must use telehealth for waiver services)

• Guidance on Medicaid Changes to Private Duty Nursing (PDN) Policy – (Web) – (PDF) – 3.28.2020

• Guidance on Medicaid Changes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Policy – (Web) – (PDF) – 3.28.2020

ADULT DAY CARE PROGRAMS - Medical Model and Social Model

• Adult Day Health Care centers - closed  (March 13, 2020) (Medical Model programs only; DOH does not regulate social adult day care but they are apparently also closed) 

  • Medical Model ADHC programs may offer telehealth services --  COVID–19 Telephonic and Telehealth Services Available to Statewide Adult Day Health Care Program Services – (Web) – (PDF) 03.28.20.  COMMENT:  MLTC plans should continue to contract with ADHC for telehealth. 

  •  4/7/20 - Social Adult Day Care programs may offer telehealth services for MLTC plans - COVID-19 Guidance for Providing Adult Social Day Care (SDC) Services Telephonically. (Web) - (PDF) 

  • Questions and Answers Related to COVID-19 Guidance for Providing Adult Social Day Care (SDC) Services Telephonically, (May 16, 2020)(MLTC plans REQUIRED TO offer telephonic/telehealth  SDC services to members, and plan must reach out to members who received the SDC service before they closed down 3/18, and offer either telehealth or telephone services from SDC.  (NOTE that does not require MLTC to offer increased home care services in lieu of the day care services)  

    • SDC programs may offer home-delivered meals, and MLTC plan can contract with the SDC to provide them.  

Nursing Homes and Adult Care Facilities - Assisted Living

•  Limited Visitation Permitted for Facilities Without COVID-19 for at Least 14 Days  (NYS 9/15/20), which NYS DOH issued just before CMS also issued guidance opening up visitation in nursing homes. Nursing Home Visitation - COVID-19 (CMS, 9/17/20)

• Deaths in Nursing Homes from COVID - by NH (y NYS DOH - blast updated July 28, 2020 - check link for frequent updates)

• Visitation in Adult Care Facilities - rules for visitation in Phase 3 areas (July 10, 2020)

• Health Advisory: COVID-19 Cases in Nursing Homes and Adult Care Facilities  (Mar. 13, 2020, revised July 10, 2020)(limited visitation expanded to Long Term Care Ombudsprogram) 

• DAL 20-14: Required COVID-19 Testing for all Nursing Home and Adult Care Facility Personnel (requires weekly testing of all staff including private or Medicaid aides) (May 11, 2020)

• Advisory: Hospital Discharges and Admissions to Nursing Homes (Mar. 25, 2020)(Nursing homes must automatically re-admit residents who are temporarily hospitalized, even if they test positive for COVID-19)

• Guidance Regarding Adult  Care Facilities and CoronaVirus (Mar. 22, 2020)

• Recommendations to Protect Nursing Home Residents (Mar. 20, 2020)

• Health Advisory: Respiratory Illness in Nursing Homes and Adult Care Facilities in Areas
  of Sustained Community Transmission of COVID-19 (Mar. 21, 2020)

• Nursing Home Guidance Letter (March 11, 2020)

9. Web resources - compilations of policies - Medicaid, Medicare, etc.

• WNYLC - Links to State Government Policies re Covid-19 for Legal Services Advocates and Clients  - compiles links for numerous state agencies and for New York City concerning housing, benefits, court access, health care, employment, etc.

• United Hospital Fund - Grim Times &  Health Insurance - Maintaining Coverage in NYS in the Pandemic

• Center for Medicare Advocacy Resources on Covid-19

• Medicare Rights Center blog on Covid-19 and Medicare

• Justice in Aging Resources for Advocates Working with Older Adults 

• National Health Law program https://healthlaw.org/coronavirus-resources/ 

• NYS Coalition for the Homeless COVID-19 Resources

This article written by Evelyn Frank Legal Resources Program, NYLAG  eflrp@nylag.org  Check back for updates