Federal and state law set time limits for processing a Medicaid application. The federal Medicaid Act requires eligibility to be determined with "reasonable promptness." A determination of eligibility for Medicaid must generally be made within a 45-day time period, with two exceptions.
Determinations of eligibility for pregnant women and children under age 19 must be completed within 30 days.
Cases awaiting a disability determination have a 90-day time limit. If the eligibility determination process for determining disability takes more than 90 days, on or before the 90th day, the applicant should be sent a written statement stating the reasons for the delay. When the applicant is eligible under a different category, Medicaid is authorized for the interim period.
Despite the clear time limits in law and regulation, many local districts take much longer time to process Medicaid applications. Various lawsuits have been filed over the years seeking to enforce compliance with the federally mandated time limits. Information about some of the lawsuits in NYS can be found at the links below. The links include contact information for plaintiffs' counsel.
Contempt Motion Responds to Suffolk County’s Failure to Provide Promised Food and Medical Assistance Promptly (February 2012)(Maryann v. DeMarzo, Doe v. Blass)
Martin v. Weiner (W.D.N.Y. 2008 settlement)
Reynolds v. Giuliani, 35 F. Supp. 2d 331 (S.D.N.Y.1999), modified on other grounds, 43 F. Supp.2d 492 (S.D.N.Y. 1999) (not specifically addressing application delay processing, but NYC’s failure to permit prospective applicants to file their applications for FS, MA, and PA on the first day they visit a NYC Job Center and the failure to do separate MA and FS determinations for those applicants whose PA application is denied or withdrawn).