Financial maintenance requirements at application and renewal

 In September, 2011, NYS Department of Health (DOH) clarified the administrative directive 10ADM-06 Standardized Financial Maintenance Requirements for Medicaid Applicants/Recipients,  which in June, 2010,  established a standardized methodology by which local social services districts and facilitated enrollers (FEs) should assess how certain Medicaid/Family Health Plus applicants and recipients are meeting their living expenses.  The 2011 clarification is GIS 11MA016 - Clarification of the Financial Maintenance Policy.
The policy directive 10-ADM-06 indicates that that financial maintenance should be explored if an applicant/recipient’s monthly housing costs (rent, mortgage and/or property taxes) exceed a certain threshold relative to the household's income. The threshold is 70% in New York City, Long Island, and Westchester and Putnam counties and 60% in the rest of the state.
The policy becomes effective June 1, 2010.   When it was first introduced in June 2010:
In September 2011, DOH issued GIS 11MA016 - Clarification of the Financial Maintenance Policy.  It appears some districts may have been "abusing the process" by requiring everyone to go through the process. The GIS clarifies treatment of income of non-household members and reminds districts to only seek additional information where the "percentages are satisfied."   

This article was authored by the Empire Justice Center and updated by Selfhelp Community Services, with information provided by Jim Murphy, Legal Services of Central New York, Inc. 

Empire Justice Center

Article ID: 115
Last updated: 28 Sep, 2011
Revision: 2
Medicaid -> Financial Eligibility -> Financial maintenance requirements at application and renewal