Covid-19 Resources on Medicaid in NYS - Public Health Emergency Extended til Jan. 2022, Home Care aide vaccine deadline10/7; Telehealth assessments Resumed

This article describes laws, policies and  procedures developed by the federal government (CMS),  the NYS Department of Health (DOH), and by New York City is HRA to protect Medicaid during the Public Health Emergency.   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 -  Telehealth nurse assessments reinstated 9/30/21; VACCINE MANDATE -- HOME CARE workers must have one vaccine by Oct. 7, 2021; Public Health Emergency extended through Jan. 15, 2022

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

  3. Medicaid  Eligibility & Covid in NYS - 

  4. NYS OTDA Fair Hearing Information

  5. ADVOCACY by NYLAG and other CONSUMER ADVOCATES 

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

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

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

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

  10. Compilations of Resources from National & NYS Organizations

1.  NEWS UPDATES

 2.  Medicaid Home Care - NYS Dept. of Health

DOH guidance to Medicaid providers here and  to all health care providers at this inkSee below for some key provider directives from DOH.  

Key Medicaid  home care guidance relevant for consumers:

ADVOCACY:

3. Medicaid Eligibility Rules in the Public Health Emergency

Under Families First Coronavirus Response Act signed on March 18, 2020, establishes a moratorium on Medicaid case closings or reductions.  No Medicaid recipient will lose their coverage after March 18, 2020 through the end of the Public Health Emergency.   This is  part of the "Maintenance of Effort"  requirement contained in the Families First law - that gives States extra federal money toward Medicaid costs because of the pandemic.  

NEWS:  The Public Health Emergency has been repeatedly extended -- most recently on Oct. 15, 2021 by HHS Order.   

3a. NO MEDICAID CASE CLOSINGS OR REDUCTIONS  during Public Health Emergency - Automatically Extensions at Renewal  - and Spend-down cannot be Increased 

3b.  STATE and NYC MEDICAID POLICIES:

NYS Directives

New York City Directives - also see NYC HRA Health Assistance Webpage

3.c. APPLICATIONS

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?

  1. IMMEDIATE NEED HOME CARE applications  E-FAX 1-917-639-0665. DO NOT fax other applications here. 

  2. Authorized Submitters (C-REPs) ONLY can fax to  917-639-0731 

Mail in Unit
MICSA
505 Clermont, 5th Floor
Brooklyn, NY 11238

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

... 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). 

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

5.   CONSUMER ADVOCACY - by NYLAG and OTHER CONSUMER ORGANIZATIONS 

NURSING HOMES -

HOME CARE

MEDICAID FAIR HEARINGS - NYS Office of Temporary & Disability Assistance

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

Emergency Services Only” Coverage - Medicaid Update Number 7March 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.

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

Clarifies that the one-time Stimulus payments and the $600 weekly Pandemic Unemployment compensation are not countable income for Medicaid, including under post-eligibility budgeting used in nursing home Medicaid, meaning that the payments will not be counted toward the NAMI (Net Available Monthly Income).  
CARES ACT: ...Notwithstanding any other provision of law, any refund (or advance payment with respect to a refundable credit) made to any individual under this title shall not be taken into account as income, and shall not be taken into account as resources for a period of 12 months from receipt, for purposes of determining the eligibility of such individual (or any other individual) for benefits or assistance (or the amount or extent of benefits or assistance) under any Federal program or under any State or local program financed in whole or in part with Federal funds. 

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

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

9. 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 

VACCINE MANDATE - New York joined a growing list of states Thursday, Aug. 26th mandating COVID-19 vaccinations for licensed home healthcare and home care agencies. The New York State Health Department’s Public Health and Health Planning Council unanimously passed an emergency regulation that will require workers at those agencies to have their first shots by Oct. 7.  This expands the vaccination mandate announced on August 16th requiring all staff of nursing homes, other congregate care setings, and hospitals to have first shots by Sept. 27th. 

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.”   

HOME CARE, WAIVER PROGRAMS, PRIVATE DUTY NURSING, DME

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.

ADULT DAY CARE PROGRAMS - Medical Model and Social Model

Nursing Homes and Adult Care Facilities - Assisted Living

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

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



19 Oct, 2021
Covid-19 Resources on Medicaid in NYS - Public Health Emergency Extended til Jan. 2022, Home Care aide vaccine deadline10/7; Telehealth assessments Resumed
http://www.wnylc.com/health/news/86/