NYC Medicaid Application Changes!! New "Supplement A" form required in All Applications and Must be Signed by Spouse
08 Jan, 2021
HRA recently posted a new Medicaid Alert - Asset Verification System Expanded to all DAB/SSI Related Submissions (Dec.22, 2020). Why this electronic system is expanding is explained below. But buried in the Alert is the bigger news -- some big changes for filing all Medicaid applications in NYC for people age 65+, disabled, or blind.
Here are the big changes:
1. NEW SUPPLEMENT A FORM DOH-5178A
Use DOH-5178A - the same form that has been used outside of NYC. DO NOT USE Form DOH-4495A, which has been used in NYC until now.
The form and the entire Medicaid application can also be found in various languages at https://www.health.ny.gov/health_care/medicaid/. Click on the dropdown for General Medicaid FAQs, then on the dropdown for "What Do I Need to Apply For Medicaid?" Beware that this website still has the old 4495A Supp A form posted, along with the new 5178A form. Here are links to translations of the new 5178A form:
2. SUPPLEMENT A is now required for ALL Applications for people Age 65+, Disabled or Blind - not just those seeking home care or other community-based long term care.
3. SPOUSES MUST SIGN the new SUPPLEMENT A, even if using SPOUSAL REFUSAL or even if NOT APPLYING.
WHAT HAPPENS IF YOU USE THE WRONG SUPPLEMENT A FORM, or don't SUBMIT IT AT ALL?
Since 2017, the State has required local Medicaid programs to implement an electronic Asset Verification System (AVS) that verifies accounts held in banking institutions or real property owned by the applicant. See 17ADM-02 - Asset Verification System with attachments here. NYC HRA has implemented this gradually - first in Nursing Homes in 2018 and then in hospital applications in 2019. NYC is now implementing it in community applications.
NYLAG suspects that HRA has been under pressure to expand AVS for years, but that the impending new LOOKBACK for community-based long term care is lighting a fire. See information here about the new lookback, which will eventually be 30 months, that is scheduled to begin April 1, 2021. AVS will be of some help in the lookback, as HRA will have access to bank account and real property information, so submission of those records will hopefully not be required. (Of course applicants and their representatives still should review them as any large withdrawals or payments must be explained to show they are not transfers of assets, or to show that deposits do not reflect unreported income or accounts). AVS does not include investment accounts, annuities, or IRA's, however.
Where Can You Find Other HRA Medicaid Alerts?
Unfortunately, HRA does not post these for the general public. Organizations registered as "authorized submitters" of Medicaid applications - also known as "C-REP" submitters - receive emails alerting them to these alerts that are posted on the MAP Authorized Resource Center (MARC) - NYC.gov. For your organization to become an authorized submitter its employees need to sign up for attend trainings on Medicaid eligibility and applications. See information on the MARC website.
NYLAG re-posts Medicaid Alerts of general interest on this website -- in this article Medicaid Alerts & Other Protocols published by the NYC HRA Medical Insurance and Community Services Administration (MICSA) and in applicable articles.
Information about the new Supplement A requirements is also posted in this article - Applying for Medicaid Personal Care or CDPAP Services in New York City - 2021 Changes.
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