Medicaid Alerts & Other Protocols published by the NYC HRA Medical Insurance and Community Services Administration (MICSA)

HRA MICSA Alerts are periodic announcements of policy, staff and office changes published by the Medical Insurance and Community Services Administration (MICSA).  MICSA is the part of New York City’s Human Resource Administration (HRA) that administers HRA’s medically- related programs such as the Medical Assistance Program (MAP). MAP determines which New Yorkers are eligible for Medicaid and Family Health Plus. MICSA also administers the Home Care Services Program (HCSP).  HCSP CASA's administer NYC'S home care programs for Medicaid eligible elderly and disabled New Yorkers.

 When policy changes occur within MICSA’s programs considered important enough to be of concern to Home Care Providers, Home Health agencies, hospitals, and other community based organizations, MICSA sends out an announcement of the changes  known as a Medicaid Alert.  These announcements are sent out to community based organizations periodically throughout the year. 
Medicaid Alerts may be useful by advocates in verifying policy changes to frontline Medicaid workers.    We have compiled ones that are pertinent as of November 2010.   They are organized in 3 general categories:  
Within each category, they are listed chronologically with a KEY TOPIC for ease in finding pertinent directives.
Please email us to provide any other HRA Medicaid directives that might be helpful to others..   

MEDICAID ELIGIBILITY AND PROCEDURES

DATE             TOPIC                                   TITLE

2017

2017-12-13   Applications/Eligibility Requirements  Medicare Enrollment Required.   See this article for more info. 

2017-12-04   Applications        Application Dates and Deferral Timeframes - Changes deadline for applicants to respond 
                                                   to a "deferral" or request by local DSS for additional documents to support application. 
                                                   Everyone gets 15 calendar days to respond, except for nursing home applicants  (5-year
                                                   lookback) get 21 calendar days.  Consumer may request an extension by submitting new
                                                   form  MAP-3062a manually to the department where they submitted application. 
                                                   Decision granting or denying extension will be on form MAP-3062b (sample attached to                                                     the Alert.

2017-07-26    Pooled Trusts    Powers of Attorney and Statutory Gift Rider - Requires that POA's executed after Sept. 1,
                                                   2009 must include a Statutory Gift Rider in order for agent to establish a pooled trust.

2017-05-11   Renewals            Revised Disabled, Aged, Blind (DAB) Renewal Form and On-line Reprints of DAB
                                                   Renewal  Form on  www.nyc.gov/accessnyc

2017-04-26    Transportation   New Contractor for NYC Medicaid transportation - LogistiCare - (formerly MAS - Medical Answering Services LLC)  Has contact info.

2016              

2016-12-15 Changes in Medicaid Coverage for Temporary Non-Immigrants Temporary Non-Immigrants

2016-09-23   Medicaid Applications & Personal   Immediate Need Applications - Personal Care and CDPAP
                   Care  & CDPAP                                      Procedure and Transmittal Form HCSP 3052

2016-04-04  HIPAA Release         MAP-751d Authorization for Disclosure of Health Information replaced by   
                                                       OCA Form No. 960 - Authorization for Release of Health Information Pursuant to                                                                     HIPAA   Download Alert here.

2015

2015-10-28  Nursing Home & Managed Care    Nursing Home Transition into Managed Care:  Forms & PDF Training Material  (lists new forms which are attached in PDF including:

2015-10-26 Nursing Home & Managed Care - MICSA/NHED Submission Protocol for Transition of Nursing Home Benefit  into Medicaid Managed Care

2015-08-31   Spend-Down/ Surplus  NYC MICSA Alerts 8/31/15 & 5/18/15 re Payment of Surplus Bills or Pay-in by Third Parties with accompanying form MAP-3107a Attestation of Use of Recipient Funds to pay Surplus

2015-06-15 Nursing Home       MAP-648 P Nursing Home Medicaid Transmittal

2015-06-03 MA Eligibility-MAGI        Treatment of Income of a Dependent under MAGI-Like Budgeting.  Implements NYS DOH GIS GIS 15 MA/008 - Treatment of Income of Dependents Under MAGI-like Rules  PDF 

2015-06-02  Nursing Home       Policy Change for the Start Date of the Transfer of Assets Look Back Period

2015-03-10  MA Eligibility        Newborn Processing Update

2015-04-27  MA Eligibility        MAPDR-01  2014 NYS Medicaid Income & Resource Standards with Federal Poverty 
                                                       Levels (new version includes MAGI as well as NON-MAGI income levels)

2015-04-03 Nursing Home       Transition of Long Term Nursing Home Benefit into Medicaid Managed Care

2015-03-31 Nursing Home       Nursing Home Eligibility Division Expedited Renewal Protocol

2015-03-10   Transition Exchange to LDSS  Consumers with Medicaid on Exchange Needing Enrollment into MLTC or

HIV SNP

2015-03-10 MA Eligibility         Automated Newborn Processing on WMS 

2015-02-20 MA Eligibility         Reinstatement of Suspended Medicaid Coverage for Formerly Incarcerated Individuals

2015-02-03  MA Eligibility        Medicaid Recipients Transferred at Renewal from NYS of Health to Local Dept. of Soc. Services

Procedure for transitioning people from expanded "MAGI" Medicaid generally for people under 65 who do not have Medicare -- when they turn 65 or become enrolled in Medicare, they must transfer to Non-MAGI Medicaid, using a stricter income and resource test.   The procedure provides some coverage to fill the gap during the transition.  It implements State DOH 14-LCM-02   PDF  (Dec. 2014) with Attachments to State DOH LCM:

2015-01-26 MLTC                      CASA Fact Sheet

2015-01-05 MA Eligibility          Consumers Transition from NYSOH to WMS update

2014

2014-12-09  MA Eligibility          8 Helpful Hints for Accurate Completion of the Medical Request for Home Care (M11Q)
2014-10-24  MA Eligibility          MAGI Consumers Long Term Eligibility Rules
2014-09-26  MA Procedures       Incorrect Stenson Notices to Some (2500) SSI Consumers
2014-08-26  MA Eligibility          HRA MAP Form 3097 Request for Budgeting Recipients with Excess Income Who May
                                                       Be MAGI Eligible (PDF includes FORM 3097)
2014-06-10  MA Procedures       Submission of Medicaid Application Reconsideration and Reapplication Requests - cites
to Request for Reconsideration Form MAP3069b (click here) and 3069c (unavailable)
 
2014-06-11  MA Eligibility          Consumers with Medicaid Coverage on the NYSOH (Marketplace) whose Coverage Must be Transitioned to WMS

2013

2013-12-24  Nursing Home Budgeting    2013 MAP-INF 04:  Spousal Refusal Instructions - Supplement to MAP
                    Spousal Impoverishment                                   Procedure 90-10 (community spouse entitled to spousal impoverishment monthly  income allowance (CSMIA) even if does spousal refusal as to assets) (revised per Esnard letter)

2013-12-24  MA Eligibility            Important Changes in Medicaid Application Submissions-MAGI & Non-MAGI

2013-12-20  MA Eligibility            Substantial Home Equity (Nursing Home and Community-Based LTC)

2013-12-16  MLTC                        Spousal Impoverishment & Transfer of Assets for Certain Individuals Enrolled in MLTC

2013-12-13  Transportation         Public Transportation Reimbursement Change

2013-11-13  MLTC                         FAQ - procedures for MLTC plans to enroll members who have a spend-down. 

2013-10-1    Health Exchange     NYS Health Benefit Exchange Opens October 1, 2013

2013-8-13    MLTC                       Disenrolled Housekeeping Case Consumers (MLTC)

2013-5-6     Office Relocation     PHASE V-Relocation of MICSA 34th Street Offices to Brooklyn

2013-5-1     Office Relocation     SPECIAL TBI & NHTD-Relocation fo MICSA 34th Street Office to Brooklyn

2013-4-30   Office Relocation     PHASE IV-Relocation of MICSA 34th Street Offices to Brookyn

2013-4-24   Office Relocation     PHASE II-III-Relocation of MICSA 34th Street Offices to Brooklyn

2013-4-18   LTHHCP\Lombardi   Mandatory Enrollment of LTHHCP Consumers in Managed Care

2013-4-16   Office Relocation     PHASE I-Relocation of MICSA 34th Street Offices to Brooklyn

2013-4-3    Office Relocation      Relocation of MICSA 34th Street Offices to Brooklyn

2013-3-05   MA Eligibility  Social Security Verification--No Proof of SSA Income Required at Applications or Renewals

2013-2-19   MLTC              Special Income Standard for Housing Expenses for Individuals Discharged from NH to MLTC

2013-2-14   MLTC               MLTC Submissions of Nursing Home Enrollments 

                    MLTC FORM       ** References Form HCSP-3022 known as MLTC Conversion Form (9/26/2013)


2013-1-24   Pooled Trusts Medical Evidence Gathering for Adult Disability Determinations

2012          

2012-12-28  Transportation                
Medicaid Transportation Management for Mainstream Medicaid Managed Care 
2012-11-13  PAY-IN Spend-Down      UPDATE:  Temporary Relocation of DARB Unit that Processes Pay-In Program Payments   (amends 2012-11-09 Alert)
2012-11-02 Hurricane Relief                 Medicaid Coverage - Hurricane Sandy 
2012-10-26 Home Care, Managed Care       Consumer-Directed Personal Assistance Program (CDPAP) and Managed Care
2012-09-21 Renewals                             RENEWAL STATUS INFORMATION FOR MEDICAID CONSUMERS (status of renewal available
for calling HRA Helpline 1-888-692-6116
2012-09-19  Managed Care                    Ending Managed Care Exemption for "Waiver Look-Alikes" - but allowing 6-month exemption for 
 people not in but applying for a  waiver

2012-09-06  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-07-03  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-03-27  Managed Care            MAPDR-21  Medicaid Managed Care Exemptions and Exclusions            

2011       

2011-12-30 MANUAL MAILING -      Discontinued Manual Mailing of Medicaid Alerts

2011-05-03  RENEWALS -               Expansion of Attestation of Income, Resources, and Residence for  SSI-related (DAB) Renewals

Announces expansion of ability to "attest," rather than verify with documentation, certain eligibility criteria during the annual renewals for Medicaid for "DAB" population - Disabled, Aged 65+, Blind.  May attest to income, resources, and change of residency.  This includes those receiving Community-Based Long-Term Care Services, which is new.  

2011-03-16 MEDICAID FAIR HEARINGS Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn

2010

2010-07-02  APPLICATIONS                  Financial Maintenance Requirements for Medicaid and Family Health Plus       

2010-07-01  APPLICATIONS                  Revisions to Health Insurance Application 4220 and Access NY Supplement A

2010-06-30  CITIZENSHIP PROOF         Puerto Rican Birth Certificates

2010-06-08- UNDOCUMENTED IMMIGRANTS - EMERGENCY MEDICAID
                                                       DOH 4471 Certification of Treatment of an Emergency Medical Condition Replaces MAP 2151

2010-04-26  APPLICATIONS                  Elimination of the Face to Face Interview for Medicaid Family Health Plus applicants

2010-02-26   UNDOCUMENTED IMMIGRANTS   Temporary Protected Status for Undocumented Haitian Immigrants

2010-01        2010 INCOME LEVELS     Medicaid Income and Resource Levels 2010

2010-01       MEDICARE SAVINGS PROGRAM  Disregard of Income Placed in Pooled Trust when Applying for MSP Program

2010-01        RESOURCE LEVELS         Elimination of Resource Limit for Non-SSI Related Medicaid

2008

2008-11-03 APPLICATIONS                Change of Submission Location for Client Reps

2008-06-10  ELIGIBILITY                       NYC Eliminates Drug and Alcohol Screening

2008-06-10  RESOURCE LEVELS        Resource Level Raised to $13,050

2008-04-08 RECERTIFICATIONS         Mail Renewal 30 Day Grace Period

2008-04-08  APPLICATIONS                MSP Applications Done Now by Mail 

2008-04-08  APPLICATIONS               Elimination of the Resource Test for MSP Program

2006

2006-10-06   RECERTIFICATIONS        Introduction of MAP-909E DAB Mail Renewal Form

2006-04-26   POOLED TRUSTS            Instructions for Submitting Supplemental Needs Trusts 

2005

2005-07-07   POOLED TRUSTS            Disability Determinations for Individuals with a Pooled Trust

2004

2004-06-21   BURIAL ACCOUNTS      Irrevocable Pre-Need Funeral Agreements and Burial Funds

2004-05         POOLED TRUSTS           Supplemental Needs Trusts Excluded from Medicaid Eligibility Budgeting

2001

2001-05-30   NURSING HOMES            Nursing Home Expedited Discharge Program 

MEDICAID HOME CARE - NOTE - not updated since 2012 - see above section

DATE            TOPIC                                     TITLE

2012     

2012-10-26  Home Care, Managed Care Consumer-Directed Personal Assistance Program (CDPAP) and Managed Care               
2012-09-19  Managed Care                  Ending Managed Care Exemption for "Waiver Look-Alikes" - but allowing 6-month exemption for 
 people not in but applying for a  waiver  (this affects some Medicaid personal care recipients receiving CASA home care who in summer/fall 2012 are receiving notices that their exemption from managed care has ended and they must join a mainstream managed care plan

2012-09-06  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2012-07-03  Managed Long Term Care Mandatory Enrollment into Managed Long Term Care

2011

2011-05-02  CASA III Relocated            Merger of CASA III with CASA V

2011-03-16  Home Care Fair Hearings Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn

2010

2010-08-25  Applications                      Relocation and New Address of Central Intake Office to Submit M11Q

2009

2009-11-05 APPLICATIONS                    Revised MIIQ for Home Care

2008

2008-04      RECERTIFICATIONS            Mail Renewal 30 Day Grace Period

MEDICAID/CASA OFFICE RELOCATIONS and STAFF

DATE            TOPIC                                     TITLE

2015-03-26 Office Relocation   Relocation of HRA Division of Accounts Receivable and Billing (DARB)

2015-03-26 Office Relocation   Relocation of HRA Headquarters to 4 World Trade Center

2014

2013

2013-9-18       CASA Field Offices                    CASA Directory

2012

2012-11-13  PAY-IN Spend-Down      UPDATE:  Temporary Relocation of DARB Unit that Processes Pay-In Program Payments   (amends 2012-11-09 Alert)
2012-11-02 Hurricane Relief                 Medicaid Coverage - Hurricane Sandy 

2011

2011-03-16   OFFICE MOVED             Relocation of Fair Hearing and Conference Unit to 111 Livingston St.,Brooklyn

2010

2010-10-14 OFFICE MOVED              Relocation of the CASA VII Office.

2010-10-12 OFFICE MOVED              Relocation of the Long Term Health Care Program Brooklyn Units 

2010-08-25 OFFICE MOVED              Relocation of HCSP, Central Intake and BMPR

2010-04-22 CONTACT LIST              Updated Nursing Home Eligibility Division Telephone and Address Directory

2010-03-16 CONTACT LIST              New Contact Numbers for MAP Dialysis Unit 

2009

2009-09-11 OFFICE MOVED             NYC Health and Human Services has new office at 622 W 168th St Manhattan 

2011-05-02  CASA III Relocated            Merger of CASA III with CASA V



Article ID: 140
Last updated: 22 Dec, 2017
Revision: 94
Medicaid -> Medicaid Alerts & Other Protocols published by the NYC HRA Medical Insurance and Community Services Administration (MICSA)
http://www.wnylc.com/health/entry/140/