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Administrative Directives (ADM)
2023
2022
- 22 OHIP/ADM-01 - New York Independent Assessor for Personal Care (PCS) and Consumer Directed Personal Care Services (CDPAS) - (PDF)
2021
- 21ADM-01 - Children´s Waiver Adaptive and Assistive Technology, Environmental Modifications, and Vehicle Modifications Authorization (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- Attachment 8 (PDF)
- Attachment 9 (PDF)
- 21ADM-02 - All Care at Home (CAH) I/II Waiver-Pertinent Existing Directives Are Rescinded as the Centers for Medicare and Medicaid (CMS) 1915(c)
Home and Community Based Services (HCBS) CAH I/II Waiver Program Was Amended and Became the 1915(c) HCBS Children´s Waiver (PDF)- 21ADM-03 - Transition of Children Placed in Foster Care and NYS Public Health Law Article 29-I Health Facility Services into Medicaid Managed Care (PDF)
- 21ADM-04 - Regulatory Changes to PCS and CDPAP Effective November 8, 2021 - (PDF)
- 21 OHIP ADM/04 - (PDF)
2019
- 19ADM-03 - Assistive Technology, Environmental Modifications, and Vehicle Modifications Authorization (PDF)
- Attachment 1
- Attachment 2
- Attachment 3
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7
- 19ADM-02 - Consolidated Children´s Waiver and Medicaid Case Processing Requirements (PDF)
- Attachment (PDF)
- 19ADM-01 - Community First Choice Option (PDF)
2017
- 17ADM-01 - Medicare Enrollment at Age 65 (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 17ADM-02 - Asset Verification System (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
2016
- 16ADM-01 - Transitioning Essential Plan Consumers from WMS to NY State of Health - (Web) - (PDF)
- 16ADM-02 - Immediate Need for Personal Care Services and Consumer Directed Personal Assistance Services - (Web) - (PDF)
- Attachment (PDF)
2015
- 15ADM-01 - Transition of Long Term Nursing Home Benefit into Medicaid Managed Care - (Web) - (PDF)
- Attachment 1 (PDF)
2013
- 13ADM-01 - Changes to Family Planning Benefit Program and Family Planning Extension Program - (Web) - (PDF)
- Appendix I (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- Attachment 8 (PDF)
- Attachment 9 (PDF)
- Attachment 10 (PDF)
- 13ADM-02 - Medicaid Payment of Inpatient Hospital Claims for Incarcerated Individuals and Individuals Age 21-64 Who Are Admitted to a Psychiatric Center - (Web) - (PDF)
- 13ADM-03 - Medicaid Eligibility Changes under the Affordable Care Act (ACA) of 2010 - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- 13ADM-04 - Medicaid Application and Renewal Processing for Modified Adjusted Gross Income (MAGI) Eligibility Groups - (Web) - (PDF)
- Appendix I (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (Revised 08/05/15)(PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- Attachment 8 (PDF)
- Attachment 9 (PDF)
- Attachment 10 (PDF)
2012
- 12ADM-01 - Changes to Personal Care Services Program and Consumer Directed Personal Assistance Regulations Resulting From MRT #4652 - (Web) - (PDF)
- 12ADM-02 - Transitioning Children from Child Health Plus to Medicaid Using Express Lane Eligibility - (Web) - (PDF)
- Attachment I (PDF, 16KB, 1pg.)
- Attachment II (PDF, 58KB, 1pg.)
- 12ADM-03 - Automated Process for Maintaining Medicaid Eligibility for Individuals Admitted to a Psychiatric Center - (Web) - (PDF)
- 12ADM-04 - Automated Medicaid Renewal Expansion: Medicare Savings Program (MSP) Individuals with Fixed Incomes - (Web) - (PDF)
- Attachment (PDF)
- 12ADM-05 - Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility who Enroll into the Managed Long Term Care (MLTC) Program - (Web) - (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
2011
- 11ADM-01 - Expansion of Attestation of Income, Resources and Residence at Renewal,and Attestation of Interest Income at Application for Family Health Plus and Certain Medicaid Applicants - (Web) - (PDF)
- 11ADM-02 - Automated Enrollment into the Medicare Savings Program in Upstate New York under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- 11ADM-03 - Maintaining Medicaid Eligibility for Individuals Admitted to a Psychiatric Center - (Web) - (PDF)
- Attachment (PDF)
- 11ADM-04 - Treatment of Irrevocable Pre-Need Funeral Agreements - (Web) - (PDF)
- Attachment (PDF)
- 11ADM-05 - Transitional Medical Assistance (TMA) Eligibility Criteria Change - (Web) - (PDF)
- 11ADM-06 - Consumer Directed Personal Assistance Program (CDPAP)Scope and Procedures - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- New LDSS/Consumer/DR Agreement Posted HERE December 10, 2021
- 11ADM-07 - Medicaid Buy-In Program for Working People with Disabilities: Disregard Retirement Accounts in Determining Resource Eligibility and Increased Resource Standards - (Web) - (PDF)
- Attachment 1 (XLS)
- 11ADM-08 - Expanded Definition of "Estate" for Medicaid Recoveries - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- 11ADM-09 - Automated Medicaid Renewal for Individuals with Fixed Incomes in the Aged, Blind and Disabled Category - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
2011 (Long Term Care)
- 11LTCADM-01 - Long Term Home Health Care Program Waiver Renewal
2010
- 10ADM-01 - Elimination of the Resource Test for Non-SSI-Related Medicaid/Family Health Plus Applicants/Recipients - (PDF)
- 10ADM-02 - Medicaid Buy-In Program for Working People with Disabilities Medical Improvement Group (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- 10ADM-03 - Medicare Savings Program Enrollment under the Medicare Improvements for Patients and Providers Act of 2008 (MIPP) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- 10ADM-04 - Elimination of the Personal Interview Requirement for Medicaid and Family Health Plus Applicants (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- 10ADM-05 - Revised DOH-4220: Access NY Health Care Application and Release of DOH-4495A: Access NY Supplement A (PDF)
- Attachment 1 Application (PDF)
- Attachment 1 Fact Sheet (PDF)
- Attachment 1 Instruction (PDF)
- Attachment 1 Checklist (PDF)
- Attachment 2 Supplement A (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- 10ADM-06 Standardized Financial Maintenance Requirements for Medicaid Applicants/Recipients (PDF)
- Attachment (PDF)
- 10ADM-07 - Elimination of the State, County, Municipal and School-District Employee Exclusion for the Family Health Plus and Family Health Plus Premium Assistance Programs (PDF)
- 10ADM-08 - Childrenacute;s Health Insurance Program Reauthorization Act (CHIPRA)of 2009: Citizenship Documentation Requirements (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 10ADM-09 - Reimbursement of Paid Medical Expenses Under 18 NYCRR §360-7.5(a) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 5 MA Only-Spanish (PDF)
2009
- 09ADM-01 - Chafee Amendment - Medicaid Coverage for Youth 18 to 21 Years Old Discharged from Foster Care (PDF)
- 09ADM-02 - Family Health Plus Auto-Assignment (PDF)
- 09ADM-03 - Medicaid Extended Coverage for New York State Partnership for Long-Term Care Policyholders (PDF)
- Appendix (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
2009 (Long Term Care)
- 09LTCADM-01 - Notice and Fair Hearing Procedures for the AIDS Home Care Program
2008
- 08ADM-01 - Family Health Plus Premium Assistance Program (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- Attachment D (PDF)
- Attachment E (PDF)
- Attachment F (PDF)
- 08ADM-02 - Medicaid Presumptive Eligibility for Children (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 08ADM-03 - Maintaining Medicaid Eligibility for Incarcerated Individuals (PDF)
- Attachment I (PDF)
- Appendix 1 (PDF)
- Appendix 2 (PDF)
- Appendix 3 (PDF)
- Appendix 4 (PDF)
- Appendix 5 (PDF)
- Appendix 6 (PDF)
- 08ADM-04 - Renewal Simplification for Medicaid and Family Health Plus Recipients (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- 08ADM-05 - District of Fiscal Responsibility Change for SSI Cases and Changes to Auto-SDX Processing for Moves Into and Out of NYC (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
2008 (Long Term Care)
- 08LTCADM-01 - Nursing Home Transition and Diversion Home and Community-Based Services Waiver (PDF)
2006
- 06ADM-01 - Instructions for Implementing HIPAA Privacy Protections in LDSS(PDF)
- Attachment (PDF)
- 06ADM-02 - Transfer of Resources: Changes in the Medicaid Regional Rates for 2006(PDF)
- Attachment 1 (PDF)
- 06ADM-03 - Spousal Impoverishment Allowance Increases for 2005 and 2006 and Personal Needs Allowances for Certain Waiver Recipients(PDF)
- Attachment 1 (PDF)
- 06ADM-04 - Increased Medicaid Income and Resource Standards and Federal Poverty Levels Effective January 1, 2005 and January 1, 2006(PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- 06ADM-05 - Deficit Reduction Act of 2005 - Long Term Care Medicaid Eligibility Changes(PDF)
- Appendix (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII (PDF)
- Attachment VIII (PDF)
- Attachment IX (PDF)
2005
- 05ADM-01 - Transfer of Resources: Changes in the Medicaid Regional Rates for 2005 (PDF)
- Attachment (PDF)
- 05ADM-02 - Reduction in the Child Health Plus A (Medicaid) Income Limit for Children Age Six through Age Eighteen
from 133% to 100% of the Federal Poverty Level (PDF)
- Attachment IA (PDF)
- Attachment IB (PDF)
- Attachment IC (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- 05ADM-03 - Medicaid Front End Detection System (FEDS) Indicators (PDF)
- 05ADM-04 - Family Health Plus Program Changes Required by Chapter 58 of the Laws of 2004, Chapters 58 and 63 of the Laws of 2005 (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- 05ADM-05 - Medicare Prescription Drug, Improvement and Modernization Act of 2003 (Medicare Part D) (PDF)
2004
- 04ADM-01 - Notice and Fair Hearing Procedures For the Care at Home Medicaid Waiver Program (PDF)
- Attachment IA (PDF)
- Attachment IB (PDF)
- Attachment IIA (PDF)
- Attachment IIB (PDF)
- 04ADM-02 - Increased Medicaid Income and Resource Standards and Federal Poverty Lines Effective January 1, 2002, Januaray 1, 2003 and January 1, 2004 (PDF)
- 04ADM-03 - Transfer of Resources: Changes in the Medicaid Regional Rates for 2004 (PDF)
- Attachment (PDF)
- 04ADM-04 - Spousal Impoverishment Allowance Increases for 2004 (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- 04ADM-05 - Medicaid Buy-In Program for Working People With Disabilities (MBI-WPD): Transition of the MBI-WPD Program to Local District Staff (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII (PDF)
- 04ADM-06 - Resource Documentation Requirements for Medicaid Applicants/Recipients (Attestation of Resources) (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII (PDF)
- Attachment VIII (PDF)
- Attachment IX (PDF)
- Attachment X (PDF)
- Appendix I (PDF)
- 04ADM-07 - Citizenship and Alien Status Requirements for the Medicaid Program (PDF)
- Attachment A-1 (PDF)
- Attachment A-2 (PDF)
- Attachment B-1 (PDF)
- Attachment B-2 (PDF)
- Attachment C (PDF)
- Attachment D-1 (PDF)
- Attachment D-2 (PDF)
- Attachment D-3 (PDF)
- Attachment D-4 (PDF)
- Attachment E-1 (PDF)
- 04ADM-08 - Aliessa/Adamolekun v. Novello Implementation of Retroactive Relief to Class Members (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV-A (PDF)
- Attachment IV-B (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII-A (PDF)
- Attachment VII-B (PDF)
- Attachment VIII (PDF)
- Attachment IX (PDF)
2003
- 03ADM-01 - Elimination of Conditional Eligibility and Changes in the Treatment of a Homestead (PDF)
- 03ADM-02 - Mail-in Renewal (Recertification) Process for Medicaid/Family Health Plus/Child Health Plus A (PDF)
- 03ADM-03 - Privacy Notice as required under the Health Insurance Portability Accountability Act (HIPPA) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 03ADM-04 - Interim Implementation of the Medicaid Buy-In Program for Working People with Disabilities (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII (PDF)
- 03ADM-05 - Transfer of Resources: Changes in the Medicaid Regional Rates for 2003 (PDF)
- Attachment (PDF)
- 03ADM-06 - Medicaid Provider Audit Activities (PDF)
- 03ADM-07 - Spousal Impoverishment Allowance Increases for 2002 and 2003 (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
2002
- 02ADM-01 - Medicaid Income Eligibility Standard of 200% FPL for Pregnant Women and Infants Under the Age of One Year (PDF)
- 02ADM-02 - Transfer of Resources: Changes in Medicaid Regional Rates for 2002 (PDF)
- 02ADM-03 - Medicaid Liens and Recoveries (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 02ADM-04 - Notice and Fair Hearing Procedures for the Long Term Home Health Care Program (PDF)
- Appendix I (PDF)
- AttachmentIA (PDF)
- Attachment IB (PDF)
- Attachment IIA (PDF)
- Attachment IIB (PDF)
- Attachment IIIA (PDF)
- Attachment IIIB (PDF)
- Attachment IV (PDF)
- Attachment VA (PDF)
- Attachment VB (PDF)
- Attachment VIA (PDF)
- Attachment VIB (PDF)
- 02ADM-05 - Recertification Procedures for the Family Health Plus Program (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- 02ADM-06 - Provision of Hospice Care in Adult Care Facilities and Assisted Living Programs (PDF)
- 02ADM-07 - Family Planning Benefit Program (PDF)
- Attachment IA (PDF)
- Attachment IB (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
2001
- 01ADM-01 - Reauthorization Procedures for Children who Applied for Medicaid (CHPlus A) Through Facilitated Enrollment (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- Attachment D (PDF)
- Attachment E (PDF)
- Attachment F (PDF)
- 01ADM-02 - Increased Medicaid Income and Resource Standards and Federal Poverty Lines Effective January 1, 2001 (PDF)
- Attachment (PDF)
- 01ADM-03 - Transfer of Resources: Changes in the Medicaid Regional Rates for Years 2000 and 2001 (PDF)
- 01ADM-04 - Spousal Impoverishment Allowance Increases for 2001 and Treatment of Institutionalized Spousesacute; Social Security Benefits and Requests for Additional Resource Allowances (PDF)
- 01ADM-05 - Automatic Medicaid Enrollment for Newborns (Chapter 412 of the Laws of 1999) (PDF)
- 01ADM-06 - Eligibility Requirements for the Family Health Plus Program, Facilitated Enrollment of Adults into Medicaid and Family Health Plus (PDF)
- Attachment I - Application (PDF)
- Attachment I - Checklist (PDF)
- Attachment I - Cover (PDF)
- Attachment I - Fact Sheet (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- Attachment VI (PDF)
- Attachment VII (PDF)
- Attachment VIII (PDF)
- Attachment IX (PDF)
- Attachment X (PDF)
- Attachment XI (PDF)
- Attachment XII English (PDF)
- Attachment XII Español (Spanish) (PDF)
- Attachment XIII (PDF)
- Attachment XIV (PDF)
- Attachment XV (PDF)
- Attachment XVI (PDF)
2000
- 00ADM-01 - Spousal Impoverishment: Allowance Increases for 2000 (PDF)
- 00ADM-02 - Facilitated Enrollment of Children into Medicaid, Child Health Plus, and WIC (PDF)
- 00ADM-03 - Transfer of Resources: Changes in the Medicaid Regional Rates for 1999 (PDF)
- 00ADM-04 - Care at Home Medicaid Waiver Home Adaptations and Vehicle Modification (PDF)
- 00ADM-05 - Increased Medicaid Income and Resource Standards and Federal Poverty Lines Effective January 1, 2000 (PDF)
- Attachment (PDF)
- 00ADM-06 - Post-Eligibility Treatment of Income of Institutionalized Individuals: Application of Income to Cost of Care (PDF)
- Attachment V (PDF)
- 00ADM-07 - Medicare Premium Payment Program (PDF)
- 00ADM-08 - Increase in Level of Substantial Gainful Activity (SGA) to $700 (PDF)
- 00ADM-09 - Citizenship and Alien Status Requirements for the Medicaid Program (PDF)
1999
- 99ADM-01 - Funding for Medicaid Implementation of Alcohol and Substance Abuse Screening and Assessment and Automated Finger Imaging System Requirements (PDF)
- Attachment D (PDF)
- 99ADM-02 - Transfer of Resources: Changes in the Medicaid Regional Rates for 1998 (PDF)
- 99ADM-03 - Implementation of the Medicaid and Title XXI Provisions of the Balanced Budget Act of 1997 (PDF)
- 99ADM-04 - Spousal Impoverishment: Allowance Increases for 1999 (PDF)
1998
- 98ADM-01 - Spousal Impoverishment: Allowance Increases for 1998 (PDF)
- 98OCCADM-01 - Limited Licensed Home Care Services Agencies (LLHCSAs) (PDF)
- Attachment A: Guidelines for Service Responsibility (PDF)
- Attachment B: Notice Letter 1 (PDF)
- Attachment B: Notice Letter 2 (PDF)
- Attachment B: Notice Letter 3 (PDF)
- Attachment B: Notice Letter 4 (PDF)
- Attachment C: LLHCSA Rates and Rate Codes (PDF)
- Attachment D: Model Contract (PDF)
- 98ADM-02 - Fiscal Assessment for Private Duty Nursing Services (PDF)
- Attachment (PDF)
- 98ADM-03 - Medicaid Referrals from the Child Health Plus Program (PDF)
- Attachment (PDF)
- 98ADM-04 - "Medicare Premium Payment Program" Application (SLIMB, QI-1 and QI-2) (PDF)
- 98ADM-05 - Enhanced Federal Funding for Implementation of Certain Medicaid Welfare Reform Requirements (PDF)
- 98ADM-06 - Increased Medicaid Income and Resource Standards and Federal Poverty Lines Effective - January 1, 1998 and June 1, 1998 (PDF)
- 98ADM-07 - Certificates of Creditable Coverage (CCC) (PDF)
1997
- 97ADM01 - District of Fiscal Responsibility (PDF)
- 97ADM02 - Medicaid Implications of Welfare Reform (PDF)
- 97ADM03 - Spousal Impoverishment: Allowance Increases for 1997 (PDF)
- 97ADM04 - Transition of New York State Veteransacute; Home at Oxford Medicaid Cases to Local District Responsibility (PDF)
- 97ADM05 - Increased Medical Assistance Income and Resource Standards and Federal Poverty Lines for 1997 (PDF)
- 97ADM06 - Immunization Information for PA Applicants and Recipients (PDF)
- 97ADM07 - Public Assistance Treatment of Support Collections; Calulation, Issuance and Budgeting of Excess Support Payments (PDF)
- 97ADM08 - Recategorization of ADC and CAP Cases as a Result of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) (PDF)
- 97ADM09 - Foster Care and Child Day Care: Policy on the Provision of Both Services by an Indiviudal (PDF)
- 97ADM010 - Presumptive Medicaid Eligibility for Nursing Facility, Hospice, or Home Health Care Services (PDF)
1996
- 96ADM01 - Payment for Reserved Beds in Medical Institutions: Clarification of Policy (PDF)
- 96ADM02 - Multiethnic Placement Act of 1994 (PDF)
- 96ADM03 - Child Care: Revised Market Rates (PDF)
- 96ADM04 - The Automated Finger Imaging System (AFIS) for Public Assistance (PDF)
- 96ADM05 - Article VII Changes - 1995/96 State Budget
- Attachment (PDF)
- 96ADM06 - Medicare Maximization for Nursing Facility Care (PDF)
- 96ADM07 - Refugee Cash and Medical Assistance Program (RCA & RMA)
- Attachment (PDF)
- 96ADM08 - OBRA acute;93 Provisions on Transfers and Trusts
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 96ADM09 - Utility Arrears Repayment Agreement (PDF)
- 96ADM010 - Increased Medical Assistance Income and Resource Standards and Federal Poverty Lines for 1996
- Attachment I (PDF)
- 96ADM011 - Spousal Impoverishment : Community Spouse Resource Amount (PDF)
- 96ADM012 - Submission of Local Plans for Exempt Areas 1995-96 State Share Administrative Cap (PDF)
- 96ADM013 - Limitations on Home Relief Benefits for New Residents CANCELLED (PDF)
- 96ADM014 - Spousal Impoverishment: Allowance Increases for 1996 (PDF)
- 96ADM015 - Excess Income Program Clarifications/Prepayment of Client Liability (Pay-In) Program
- Attachment II (PDF)
- Attachment VI(a) (PDF)
- Attachment VI(b) (PDF)
- Attachment VI(c) (PDF)
- Attachment VI(d) (PDF)
- 96ADM016 - FOSTER CARE: Retention of Income by Child in Foster Care (Use of Trust Funds to Preserve Savings) (PDF)
- 96ADM017 - Transfer of Resources: Changes in the Medical Assistance Regional Rates for 1996 (PDF)
General Information System Messages (GIS)
2024
- GIS 24 MA/08 - 1915(c) Children’s Waiver Home and Community Based Services Waiver - Recipient Restriction Exception “K” Codes (PDF)
- GIS 24 MA/07 - Continuation of Certain Policy Easements and Other Processes After Expiration of the Public Health Emergency Unwind Period (PDF)
- GIS 24 MA/07 - Desk Aid: SSI-R Chart (PDF)
- GIS 24 MA/06 - PRUCOL Categorization and Revised Documentation Guide for Citizen and Non-Citizen Eligibility for Health Insurance Coverage in New York State Updates (PDF)
- GIS 24 MA/06 - Documentation Guide (PDF)
- GIS 24 MA/05 - 2024 Update to the Actuarial Life Expectancy Table (PDF)
- GIS 24 MA/05 - Life Expectancy Table (PDF)
- GIS 24 MA/04 - Medically Fragile or Developmentally Disabled and Medically Fragile Consumers enrolled in the 1915(c) Children’s Waiver and County’s Children Single Point of Access (C-SPOA) role (PDF)
- GIS 24 MA/03 - Children’s Waiver Environmental Modifications, Vehicle Modifications, and Adaptive and Assistive Technology Authorization (PDF)
- GIS 24 MA/02 - Clarification on the Immediate Need Process for Personal Care Services (PCS) and Consumer Directed Personal Assistance Services (CDPAS) through the New York Independent Assessor Program (NYIAP) (PDF)
- GIS 24 MA/01 - 2024 Federal Poverty Levels (PDF)
- GIS 24 MA/01 - Attachment I (PDF)
2023
- GIS 23 MA/24 - Procedure Change for Rest of State in the Suspension of Medicaid for Justice Involved Juveniles (PDF)
- GIS 23 MA/23 - 2024 Medicaid Levels and Other Updates (PDF)
- GIS 23 MA/23 - Attachment I (PDF)
- GIS 23 MA/22 - Sex 'X' and Gender Identity Updates to Certain Application Forms (PDF)
- GIS 23 MA/22 - Attachment I (PDF)
- GIS 23 MA/21 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2024 (PDF)
- GIS 23 MA/20 - Expanded Monthly Transition from WMS to NY State of Health (PDF)
- GIS 23 MA/20 - Attachment I (PDF)
- GIS 23 MA/20 - Attachment II (PDF)
- GIS 23 MA/19 - Notice to LDSSs about Receiving Contact/Address Updates from NYMC (PDF)
- GIS 23 MA/18 - Clarification on Legal Guardians Serving as CDPAP Personal Assistant (PDF)
- GIS 23 MA/17 - Revised DOH-4220: Access NY Health Care Application (PDF)
- GIS 23 MA/17 - Attachment I (PDF)
- GIS 23 MA/16 - Clarification of Permanently Residing Under Color of Law (PRUCOL) when Requesting Relief on Non-Official Forms (PDF)
- GIS 23 MA/16 - Attachment I (PDF)
- GIS 23 MA/15 - Updates to Prior Approval and Renewal Process for Out-of-State Skilled Nursing Facility Placement (PDF)
- GIS 23 MA/14 - Updates to Medicaid Renewals and Other Processes in the Unwind Period (PDF)
- GIS 23 MA/14 - Attachment I (PDF)
- GIS 23 MA/14 - Attachment II (PDF)
- GIS 23 MA/14 - Attachment III (PDF)
- GIS 23 MA/13 - NYS Medical Indemnity Fund, the 1915 (c) Home and Community Based Services Waivers, Department of Health (DOH) Children's Waiver and OPWDD Comprehensive Waiver (PDF)
- GIS 23 MA/12 - HIPP Calculator Rate Updates 2023 (PDF)
- GIS 23 MA/11 - Coordination of Hospice Services for Fee for Service Recipients and Medicaid Managed Care Enrollees (PDF)
- GIS 23 MA/11 - Update Form (PDF)
- GIS 23 MA/11 - Medicaid Enrolled Hospice Providers (PDF)
- GIS 23 MA/10 - Update to Medicare Premium Payment Process for Individuals Referred From NY State of Health to a Local Department of Social Services (PDF)
- GIS 23 MA/09 - 2023 Update to the Actuarial Life Expectancy Table (PDF)
- GIS 23 MA/09 - Life Expectancy Table (PDF)
- GIS 23 MA/08 - Clarification of Separate Determinations during COVID-19 Unwind (PDF)
- GIS 23 MA/07 - U.S. Citizenship or Immigration Status and Social Security Number Requirements for Pregnant Individuals (PDF)
- GIS 23 MA/07 - Medicaid Presumptive Eligibility for Pregnant Individuals Screening (PDF)
- GIS 23 MA/06 - Auto-Close Medicare Buy-In Process (PDF)
- GIS 23 MA/05 - Medicaid Coverage for Justice Involved Youth (PDF)
- GIS 23 MA/04 - Medicare Buy-In for Individuals Transitioning from Local Districts to NYSOH (PDF)
- GIS 23 MA/03 - Unwind of the Medicaid Continuous Coverage Requirement Related to the COVID-19 Public Health Emergency and Processing Cases Under Regular Rules (PDF)
- GIS 23 MA/02 - 2023 Federal Poverty Levels (PDF)
- GIS 23 MA/02 - New York State Income and Resource Standards for Non-magi Population (PDF)
- GIS 23 MA/01 - Transition of the Pharmacy Benefit from Managed Care to NYRx the Medicaid Pharmacy Program (PDF)
2022
- GIS 22 MA/06 - 2022 Update to the Actuarial Life Expectancy Table (PDF)
- Attachment I (PDF)
- GIS 22 MA/05 - REVISED Implementation Date for Immediate Needs Assessments Conducted by the New York Independent Assessor (NYIA) (PDF)
- GIS 22 MA/04 - Update on the Impact of Certain Federal COVID-19 Pandemic Related Payments on Medicaid Eligibility Determinations for SSI-Related Applicants/Recipients (PDF)
- Attachment I (PDF)
- GIS 22 MA/03 - Managed Long Term Care Involuntary Disenrollment Resumption - Additional Reason (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 22 MA/02 - 2022 Clarification of Duplicate Client Identification Number (CIN) Report Titles (PDF)
- GIS 22 MA/01 - 2022 Federal Poverty Levels (PDF)
- Attachment I (PDF)
2021
- GIS 21 MA/01 - Impact of the Consolidated Appropriations Act of 2021 on Medicaid Financial Eligibility (PDF)
- GIS 21 MA/02 - Procedural Change for Incarcerees who Appear on the WMS WINR5612 (Prisoner Closing Case Eligibility) Report with Exception Code "F" (Cases that Error for Other Reasons) (PDF)
- GIS 21 MA/03 - IRS Tax Form 1095-B Guidance (PDF)
- GIS 21 MA/04 - Implementation of Fiscal Intermediary (FI) Rate Structure Enacted in the SFY 2019-20 NYS Budget (PDF)
- GIS 21 MA/05 - Transition (Carve-Out) of the Pharmacy Benefit from Managed Care to Fee-for-Service (FFS) (PDF)
- GIS 21 MA/06 - 2021 Federal Poverty Levels (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- GIS 21 MA/07 - Impact of the American Rescue Plan Act of 2021 on Medicaid Financial Eligibility (PDF)
- GIS 21 MA/08 - Delay of Transition (Carve-Out) of the Pharmacy Benefit from Managed Care to Fee-for-Service (FFS) (PDF)
- GIS 21 MA/09 - Auto-Close Medicare Buy-In Process (PDF)
- GIS 21 MA/10 - TPL Buy-In Deletion Report (TRMP0067) (PDF)
- GIS 21 MA/11 - Electronic Submission of Reimbursement Claims (PDF)
- Attachment I (PDF)
- GIS 21 MA/12 - Reminders of Case Processing Requirements and Notification of a New Requirement for Individuals Released from the New York State Department of Corrections and Community Supervision (PDF)
- GIS 21 MA/13 - Manual LDSS-3183, "Provider or Managed Long-Term Care Plan and Recipient Letter" (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 21 MA/14 - Revised Documentation Guide for Citizen and Non-Citizen Eligibility for Health Insurance Coverage in New York State and Related Reference Documents (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- GIS 21 MA/15 - Impact of the Child Tax Credits (American Rescue Plan Act of 2021) on Medicaid Financial Eligibility (PDF)
- GIS 21 MA/16 - Care at Home I/II Waiver Transition to the Children's Waiver (PDF)
- GIS 21 MA/17 - Managed Long Term Care's Involuntary Disenrollment Resumption (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 21 MA/18 - Provider Letter for Foster Children (OHIP-0129) (PDF)
- GIS 21 MA/19 - 2021 Update to the Actuarial Life Expectancy Table (PDF)
- Attachment I (PDF)
- GIS 21 MA/20 - Medicaid Advantage Plans Closing (PDF)
- GIS 21 MA/21 - Revised Process for Restriction/Exception Codes for Transgender Individuals (PDF)
- GIS 21 MA/22 - Revised DOH-4220: Access NY Health Care Application (PDF)
- Attachment I (PDF)
- GIS 21 MA/23 - Medicaid Eligibility for Evacuees from Afghanistan (PDF)
- Examples (PDF)
- GIS 21 MA/24 - Managed Long Term Care Involuntary Disenrollment Resumption – Additional Reasons (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 21 MA/25 - 2022 Medicaid Levels and Other Updates (PDF)
- Attachment I (PDF)
- GIS 21 MA/26- Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2022 (PDF)
2020
- GIS 20 MA/01 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2020 (PDF)
- GIS 20 MA/02 - 2020 Federal Poverty Levels (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- GIS 20 MA/03 - Clarification of GIS 19 MA/04, "Clarification of Policy for Treatment of Income Placed in Medicaid Exception Trusts" (PDF)
- Attachment I (PDF)
- GIS 20 MA/04 - Coronavirus (COVID-19) - Medicaid Eligibility Processes During Emergency Period (PDF)
- GIS 20 MA/05 - Impact of the Coronavirus Aid, Relief and Economic Security (CARES) Act on Medicaid Financial Eligibility (PDF)
- GIS 20 MA/06 - MLTC Enrollees Receiving Long Term Nursing Home Care - "Batch" Disenrollment Process (PDF)
- Attachment I (PDF)
- GIS 20 MA/07 - Non-emergency Transportation in the Consumer Directed Personal Assistance Program (PDF)
- GIS 20 MA/08 - 2020 Update to the Actuarial Life Expectancy Table (PDF)
- Attachment I (PDF)
- GIS 20 MA/09 - MLTCP Enrollees Receiving Long Term Nursing Home Care – "Batch" Disenrollment Process – Second Run (PDF)
- Attachment I (PDF)
- GIS 20 MA/10 - Correction of Multiple Client Identification Numbers (CINS) on WMS (PDF)
- GIS 20 MA/11 - Update to GIS 20/MA 04 - Coronavirus (COVID-19) - Medicaid Eligibility Processes During Emergency Period (PDF)
- GIS 20 MA/12 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2021 (PDF)
- GIS 20 MA/13 - 2021 Medicaid Levels and Other Updates (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
2019
- GIS 19 MA/01 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2019 (PDF)
- GIS 19 MA/02 - Revised Desk Guide: "Documentation Guide to Citizenship and Immigrant Eligibility for Health Coverage in New York State" (PDF)
- Attachment (PDF)
- GIS 19 MA/03 - Public Assistance Reporting Information System (PARIS) Match and Retroactive Managed Care Disenrollments (PDF)
- Attachment (PDF)
- GIS 19 MA/04 - Clarification of Policy for Treatment of Income Placed in Medicaid Exception Trusts (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 19 MA/05 - Overview of the Retroactive Disenrollment Process: Managed Long Term Care Retroactive Disenrollment Reason Codes for Local District Use (PDF)
- GIS 19 MA/06 - 2019 Federal Poverty Levels (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
- GIS 19 MA/07 - 2019 Update to the Actuarial Life Expectancy Table (PDF)
- Attachment (PDF)
- GIS 19 MA/09 - Person Centered Service Plan Guidance for Medicaid Recipients (PDF)
- Attachment 1 (PDF)
- GIS 19 MA/11 - Changes to Countable Income for Modified Adjusted Gross Income (MAGI) Based Eligibility Determinations (PDF)
- Attachment (PDF)
- GIS 19 MA/12 - 2020 Medicaid Levels and Other Updates (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
2018
- GIS 18 MA/001 Medicaid Managed Care Transition for Enrollees Gaining Medicare - (Web) - (PDF)
- GIS 18 MA/002 Treatment of New York Achieving a Better Life Experience (ABLE) Accounts - (Web) - (PDF)
- GIS 18 MA/003 HIPP Calculator Rate Updates - (Web) - (PDF)
- GIS 18 MA/004 - 2018 Federal Poverty Levels - (Web) - (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- GIS 18 MA/005 - Continuation of State Funded Medicaid for Deferred Action for Childhood Arrivals (DACA) - (Web) - (PDF)
- GIS 18 MA/006 - Public Assistance Reporting Information System (PARIS) Match Referral for NY State of Health (NYSoH) Consumers - (Web) - (PDF)
- GIS 18 MA/007 - Treatment of Income of Dependents Under MAGI-like Rules, 2018 Update - (Web) - (PDF)
- Attachment 1 (PDF)
- GIS 18 MA/008 - 2018 Update to the Actuarial Life Expectancy Table - (PDF)
- Attachment 1 (PDF)
- GIS 18 MA/009 - Change to Medicaid Service Coordination for Individuals Served by the Office for People with Developmental Disabilities (PDF)
- GIS 18 MA/010 - Verification of Attested Income at Renewal - (PDF)
- GIS 18 MA/011 - Additional Manual Eligibility Notices Updated to Include Fair Hearing Language Informing Consumers of the Availability of Specific Policy Materials Needed to Prepare for Fair Hearings - (PDF)
- Attachment 1 (PDF)
- GIS 18 MA/012 - Special Income Standard for Housing Expenses for Certain Managed Long-Term Care Enrollees Who are Discharged from a Nursing Home - (PDF)
- GIS 18 MA/013 - Revised Claim Transmittal form OHIP-0031 - (PDF)
- Claim Transmittal form OHIP-0031 - (PDF)
- GIS 18 MA/014 - Recipient Restriction Exception Codes A1/A2 - (PDF)
- GIS 18 MA/015 - 2019 Medicaid Levels and Other Updates - (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
- Attachment V (PDF)
2017
- GIS 17 MA/001 - Change of Enrollee Address - Template Letter for Plans - (Web) - (PDF)
- Change of Enrollee Address - Template Letter for Plans - (PDF)
- GIS 17 MA/002 - Social Security Number for Non-Citizens - (Web) - (PDF)
- Social Security Number Attestation Form - (PDF)
- GIS 17 MA/003 - Voluntary Repayments for Health Insurance Premium Payments Agreement - (Web) - (PDF)
- Attachment I - Voluntary Repayment Agreement, Attachment II - Voluntary Repayment Agreement Cover Letter - (PDF)
- GIS 17 MA/004: Clarification of Presumptive Eligibility Programs and Introduction of Revised Forms - (Web) - (PDF)
- Attachment I - DOH-5224, Medicaid Presumptive Eligibility for Pregnant Women Screening Form (PDF)
- Attachment II - DOH-4441, Medicaid Presumptive Eligibility for Children Screening Form (PDF)
- GIS 17 MA/005: Federal Poverty Levels - (Web) - (PDF)
- Attachment I - NEW YORK STATE INCOME AND RESOURCE STANDARDS FOR NON-MAGI POPULATION (PDF)
- Attachment II - NON-MAGI POPULATION (PDF)
- Attachment III - New York State Income Standards for MAGI Population (PDF)
- Attachment IV - MAGI POPULATION (PDF)
- Attachment VI - REDUCTION FACTORS FOR CALCULATING MEDICAID ELIGIBILITY UNDER PICKLE AMENDMENT (PDF)
- GIS 17 MA/006: Consumer Directed Personal Assistance Program (CDPAP) Provided Out of State - (Web) - (PDF)
- GIS 17 MA/007: Income Attestation at Renewal - Reminder - (Web) - (PDF)
- Attachment - Income Attestation at Renewal: Currently Enrolled in Medicaid
- GIS 17 MA/008: Policy Change for Trusts Established for Disabled Individuals Under Age 65 - (Web) - (PDF)
- GIS 17 MA/009: Approval of 1915(c) Home and Community Based Services Care at Home(CAH) I/II Waiver Program and Application - (Web) - (PDF)
- GIS 17 MA/010: Approval of 1915(c) Home and Community Based Services Care at Home(CAH) I/II Waiver Program Process and Enrollment - (Web) - (PDF)
- Attachment - Home and Community Based Services Care at Home(CAH) I/II Waiver Program Process and Enrollment (PDF)
- GIS 17 MA/011: Treatment of Federal Income Tax Refunds and Advanced Payments - (Web) - (PDF)
- GIS 17 MA/012: Restriction/Exception Code 83 Alcohol and Substance Abuse - (Web) - (PDF)
- GIS 17 MA/013: Requirements for Participation in OPWDD Home and Community Based Services waivers - (Web) - (PDF)
- GIS 17 MA/014: Changes to Express Lane Eligibility Process - (Web) - (PDF)
- GIS 17 MA/015: Out-of-State Former Foster Care - (Web) - (PDF)
- GIS 17 MA/016: 2017 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- Attachment - 2017 Life Expectancy Table (PDF)
- GIS 17 MA/017: Introduction to Form DOH-5247 - Medicaid Authorized Representative Designation/Change Request - (Web) - (PDF)
- Attachment - English (PDF)
- Attachment - Español (Spanish) (PDF)
- Attachment - Kreyòl Ayisyen (Haitian-Creole) (PDF)
- Attachment - Italiano (Italian) (PDF)
- Attachment - 한국어 (Korean) (PDF)
- Attachment - Русский (Russian) (PDF)
- Attachment - 中 (Chinese) (PDF)
- GIS 17 MA/018: Fair Hearing Language Informing Consumers of the Availability of Specific Policy Materials Needed to Prepare for Fair Hearings - (Web) - (PDF)
- Attachment - List of Revised Manual Eligibility Notices (PDF)
- GIS 17 MA/019: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2018 - 9Web) - (PDF)
- GIS 17 MA/020 - 2018 Medicaid Levels and Other Updates - (Web) - (PDF)
- Attachment I - New York State Income and Resource Standards for NON-MAGI Population Effective January 1, 2018 (PDF)
- Attachment II - NON-MAGI Population (PDF)
- Attachment III - Reduction Factors for Calculating Medicaid Eligibility Under the Pickle Amendment (PDF)
2016
- GIS 16 MA/001 - Care At Home (CAH) I/II Waiver Quarterly Report Form, CAH I/II Waiver Retroactive Eligibility Period and CAH I/II Waiver Application Submission Process - (Web) - (PDF)
- GIS 16 MA/002 - Changes in Medicaid Coverage for Temporary Non-Immigrants - (Web) - (PDF)
- GIS 16 MA/003 - Incarcerated Temporary Non-Immigrants and Undocumented Aliens - (Web) - (PDF)
- GIS 16 MA/004 -Referrals from NY State of Health to Local Departments of Social Services for Individuals who Turn Age 65 and Instructions for Referrals for Essential Plan Consumers - (Web) - (PDF)
- GIS 16 MA/005 - Changes to eMedNY for Certain Medicaid Recipient Coverage Codes - (Web) - (PDF)
- GIS 16 MA/006 - Changes to the Statute for the Consumer Directed Personal Assistance Program (CDPAP) - (Web) - (PDF)
- GIS 16 MA/007 - 2016 Federal Poverty Levels - (Web) - (PDF)
- GIS 16 MA/008 - Voluntary Managed Care Enrollment for Nursing Home Recipients - (Web) - (PDF)
- GIS 16 MA/009 - Revised DOH-4220: Access NY Health Care Application - (Web) - (PDF)
- GIS 16 MA/010 - 2015 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- 2015 Life Expectancy Table - (PDF)
- GIS 16 MA/011 - Closing the Long Term Home Health Care Program (LTHHCP) - (Web) - (PDF)
- GIS 16 MA/012 - Applying for Entitlement Benefits - (Web) - (PDF)
- GIS 16 MA/013 - Processing Newborns in WMS - (Web) - (PDF)
- GIS 16 MA/014 - Restriction/Exception Code N9 - Pending NH Eligibility Determination - (Web) - (PDF)
- GIS 16 MA/015 - 2016 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- 2016 Life Expectancy Table - (PDF)
- GIS 16 MA/016 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2017(Web) - (PDF)
- GIS 16 MA/017 - Changes to the Loading of Drug Coverage in the Third Party Health Insurance Scope of Benefits on eMedNY - (Web) - (PDF)
- GIS 16 MA/018 - 2017 Medicaid Levels and Other Updates - (Web) - (PDF)
- New York State Income and Resource Standards for MAGI and Non-MAGI Population Effective January 1, 2017 - (PDF)
2015
- GIS 15 MA/001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2015 - (Web) - (PDF)
- GIS 15 MA/002 - Care at Home III, IV and VI Waivers: Policy Updates Regarding Waiver Eligibility - (Web) - (PDF)
- GIS 15 MA/003 - 2015 Federal Poverty Levels - Mass Re-budgeting Phase 2 - (Web) - (PDF)
- GIS 15 MA/004 - Clarification of Reimbursement Policy Regarding Third Party Health Insurance Premiums and Copayments - (Web) - (PDF)
- GIS 15 MA/005 - Address Confidentiality Program (ACP) for Victims of Domestic Violence - (Web) - (PDF)
- GIS 15 MA/006 - 2015 Long Term Home Health Care Program (LTHHCP) Expenditure Caps - (Web) - (PDF)
- Attachment 1 - (PDF)
- GIS 15 MA/007 - Policy Change for the Begin Date of the Transfer-of-Assets Look-Back Period - (Web) - (PDF)
- Attachment - (PDF)
- GIS 15 MA/008 - Treatment of Income of Dependents Under MAGI-like Rules - (Web) - (PDF)
- GIS 15 MA/009 - Discontinue Production of Certificates of Creditable Coverage - (Web) - (PDF)
- GIS 15 MA/010 - Family Planning Benefit Program Changes - (Web) - (PDF)
- GIS 15 MA/011 - Reminder of Expedited Authorization Process for Medicaid Recipients with Immediate Need for Personal Care Services - (Web) - (PDF)
- GIS 15 MA/012 - Medicaid Managed Care Exemptions and Exclusions - (Web) - (PDF)
- GIS 15 MA/013 - MBI-WPD Disability Certification and Exception Trusts - (Web) - (PDF) (54)
- GIS 15 MA/014 - Health Insurance Premium Payment (HIPP) Program Changes - (Web) - (PDF) (64)
- GIS 15 MA/015 - NYS Medical Indemnity Fund and the Care at Home III, IV and VI Waivers - (Web) - (PDF) (129)
- GIS 15 MA/016 - LDSS-639 Disability Team Review Certificate and the Care at Home Waivers III, IV and VI - (Web) - (PDF) (186)
- GIS 15 MA/017 - Personal Care/Consumer Directed Services Authorization Process for Medicaid Recipients Assessed for Participation in the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Waivers - (Web) - (PDF) (70)
- GIS 15 MA/018 - Care At Home I/II Waiver Renewal - (Web) - (PDF) (97)
- GIS 15 MA/019 - New Restriction/Exception Codes for Transgender Individuals(Web) - (PDF)
- GIS 15 MA/020 - IRS Tax Form 1095-B Guidance - (Web) - (PDF)
- GIS 15 MA/021 - 2016 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards - (Web) - (PDF)
- GIS 15 MA/022 - Continuous Coverage for MAGI Individuals - (Web) - (PDF)
- Attachment 1(PDF)
- GIS 15 MA/023 - Policy Change for Determining the Appropriate Medicaid Regional Rate for Calculating a Transfer Penalty Period and the Regional Rates for 2016 - (Web) - (PDF)
- GIS 15 MA/024 - Changes to the Regulations for the Personal Care Services Program (PCS) and the Consumer Directed Personal Assistance Program (CDPAP) - (Web) - (PDF)
2014
- GIS 14 MA/001 - Medicaid Eligibility Determinations for Immediate Medical Needs - (Web) - (PDF)
- GIS 14 MA/002 - Home Assessment Abstract/Care at Home III, IV and VI - (Web)(Web) - (PDF)
- GIS 14 MA/003 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2014 - (Web) - (PDF)
- GIS 14 MA/004 - Expansion of Mandatory Managed Long Term Care - (Web) - (PDF)
- GIS 14 MA/005 - Medicare Coverage of Barbiturate Medications - (Web) - (PDF)
- GIS 14 MA/006 - Rescinding GIS 14 MA/01 - Medicaid Eligibility Determiniations for Immediate Medical Needs - (Web) - (PDF)
- GIS 14 MA/007 - Update on Self-Employment Policy for MAGI-like Budgeting - (Web) - (PDF)
- GIS 14 MA/008 - 2014 Federal Poverty Levels - (Web) -
- (PDF)
- Attachment - (PDF)
- GIS 14 MA/009 - 2014 Long Term Home Health Care Program (LTHHCP) Expenditure Caps - (Web) - (PDF)
- Attachment - (PDF)
- GIS 14 MA/010 - 06 to 30 Conversion for MLTC Enrollees - (Web) - (PDF)
- GIS 14 MA/011 - Third Party Health Insurance - CHAMP-VA - (Web) - (PDF)
- GIS 14 MA/012 - Medicaid Applications for Individuals Incarcerated in Local Correctional Facilities - (Web) - (PDF)
- GIS 14 MA/013 - Establishing Medicaid Buy-In Program for Working People with Disabilities Eligibility at Application - (Web) - (PDF)
- GIS 14 MA/014 - Tracking Group II Disability End Dates - (Web) - (PDF)
- GIS 14 MA/015 - Affordable Care Act - Requirement to Apply Spousal Impoverishment Budgeting with Post-Eligibility Rules to Couples with a Spouse Receiving Home and Community-Based Services Pursuant to a Waiver or Enrolled in a Managed Long Term Care Plan - (Web) - (PDF)
- GIS 14 MA/016 - Long Term Care Eligibility Rules and Estate Recovery Provisions for MAGI Individuals - (Web) - (PDF)
- GIS 14 MA/017 - Expansion of the Special Income Standard for Housing Expenses to Individuals Discharged from an Adult Home and the 2014 Levels for the Special Income Standard for Housing Expenses - (Web) - (PDF)
- Attachment - (PDF)
- GIS 14 MA/018 - Authorization of Services and Program Enrollment in the Uniform Assessment System - New York (UAS-NY) - (Web) - (PDF)
- GIS 14 MA/019 - Medicaid Treatment of Temporary Assistance Intentional Program Violations - (Web) - (PDF)
- GIS 14 MA/020 - TPL BUY-IN Deletion Report TRMP0067 - (Web) - (PDF)
- GIS 14 MA/021 - Implementation of the Conflict Free Evaluation and Enrollment Center - (Web) - (PDF)
- GIS 14 MA/022 - Medicaid Eligibility for Pregnant Minors - (Web) - (PDF)
- GIS 14 MA/023 - Care at Home III, IV and VI Case Management Billing - (Web) - (PDF)
- GIS 14 MA/024 - Claim Transmittal, OHIP-0031 - (Web) - (PDF)
- Attachment - (PDF)
- GIS 14 MA/025 - Spousal Impoverishment Budgeting with Post-Eligibility Rules Under the Affordable Care Act - (Web) - (PDF)
- GIS 14 MA/026 - State Disaster Emergency in Western New York Counties - Fee-for-Service Medicaid Processes During the Disaster Emergency - (Web) - (PDF)
- GIS 14 MA/027 - Medicaid Applications for Individuals Seeking HCBS Waiver Services - (Web) - (PDF)
- GIS 14 MA/028 - 2014 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- Attachment - (PDF)
- GIS 14 MA/029 - 2015 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards - (Web) - (PDF)
- Attachment - (PDF)
- GIS 14 MA/030 - Medicaid Applications for Individuals Incarcerated in Local Correctional Facilities - (Web) - (PDF)
2013
- GIS 13 MA/001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2013 - (Web) - (PDF)
- GIS 13 MA/002 - 2013 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards - (Web) - (PDF)
- GIS 13 MA/003 - Changes to the Welfare Management System: Date of Status (DOS)/Date Entered Country (DEC) - (Web) - (PDF)
- GIS 13 MA/004 - 2013 Special Income Standards for Housing Expenses - (Web) - (PDF)
- GIS 13 MA/005 - Buy-In for Individuals with Medicare who have not applied for Social Security Retirement Benefits - (Web) - (PDF)
- GIS 13 MA/006 - Life Estate Interest Valuation - 2012 Change to IRS Website Access - (Web) - (PDF)
- GIS 13 MA/007 - UAS-NY/Care At Home I/II - (Web) - (PDF)
- Attachment I - (PDF)
- GIS 13 MA/008 - 2013 Federal Poverty Levels - (Web) - (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- GIS 13 MA/009 - Changes to Medicaid Coverage for the Treatment of an Emergency Medical Condition - (Web) - (PDF)
- GIS 13 MA/010 - Assignment of Client Identification Numbers (CIN) - (Web) - (PDF)
- Attachment I (PDF)
- GIS 13 MA/011 - Children´s Health Insurance Program Reauthorization Act (CHIPRA) Expanded Coverage for Certain Qualified and PRUCOL Aliens - (Web) - (PDF)
- GIS 13 MA/012 - Changes to the Criteria Used For Determining The Cost Benefit of Paying Health Insurance Premiums - (Web) - (PDF)
- GIS 13 MA/013 - Expansion of Automated Renewals for Aged, Blind and Disabled and Medicare Savings Program (MSP) Cases to Include Pensions - (Web) - (PDF)
- GIS 13 MA/014 - Level I Personal Care Services and Consumer Directed Personal Assistance Services in Managed Long Term Care - (Web) - (PDF)
- GIS 13 MA/015 - Fair Hearing Decisions Reversing Agency Denials of Medicaid Applications - (Web) - (PDF)
- GIS 13 MA/016 - Medicaid Managed Care Guarantee - (Web) - (PDF)
- GIS 13 MA/017 - Medicaid Exclusion/Restriction Codes - (Web) - (PDF)
- Attachment - (PDF)
- GIS 13 MA/018 - Spousal Impoverishment and Transfer of Assets Rules for Certain Individuals Enrolled in Managed Long Term Care - (Web) - (PDF)
- GIS 13 MA/019 - Demonstration Project: Centralized Medicaid Application Process for Upstate Individuals Incarcerated in a NYS Department of Corrections and Community Supervision Facility - (Web) - (PDF)
- GIS 13 MA/020 - 2013 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- Attachment - (PDF)
- GIS 13 MA/021 - Renewal Processing for MAGI Eligibility Groups Beginning January 2014 - (Web) - (PDF)
- GIS 13 MA/022 - 2014 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards - (Web) - (PDF)
2012
- 12MA001 - Required Tables/Method of Valuing Life Estate Interest - (Web) - (PDF)
- 12MA002 - Increase in the Substantial Home Equity Limit for 2012 - (Web) - (PDF)
- 12MA003 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2012 - (Web) - (PDF)
- 12MA004 - Continue Medicaid Pending a Disability Determination - (Web) - (PDF)
- 12MA005 - Elimination of Medicare Part D Cost Sharing for Certain Full Benefit Dual Eligibles - (Web) - (PDF)
- 12MA006 - New York Health Care Proxy Form - (Web) - (PDF)
- Attachment - (PDF)
- 12MA007 - Worker Notes in WMS - (Web) - (PDF)
- 12MA008 - Clarification of Self-Employment Policy and Use of the Financial Status Form (Farm or Business), DOH-4469 - (Web) - (PDF)
- 12MA009 - 2012 Federal Poverty Levels 2012 - (Web) - (PDF)
- Attachment - (PDF)
- 12MA010 - Trust Indicator Field in WMS - (Web) - (PDF)
- 12MA011 - Medicaid Coverage for Transitioning Juvenile Delinquent Youth - (Web) - (PDF)
- Attachment - (PDF)
- 12MA012 - Premium Rates for Use With the Family Health Plus Premium Assistance Program Calculator - (Web)(Web) - (PDF)
- Attachment - (PDF)
- 12MA013 - Spousal Impoverishment Budgeting with Post-Eligibility Rules for Individuals Participating in a Home - (Web) - (PDF)
- 12MA014 - Medicaid Requirements Regarding Ordering and Referring Physicians - (Web) - (PDF)
- 12MA015 - Income Attestation at Renewal - (Web) - (PDF)
- 12MA016 - Episodic Payments for Certified Home Health Agency Services and Spenddown Questions and Answers - (Web) - (PDF)
- 12MA017 - Assisted Living Program (ALP) Changes - (Web) - (PDF)
- 12MA018 - Revised Long Term Home Health Care Program (LTHHCP) Manual - (Web) - (PDF)
- 12MA019 - Individual Categorial Code "84" Children Ages Six through Eighteen from 100% FPL to 133% FPL - (Web) - (PDF)
- 12MA020 - 2012 Long Term Home Health Care Program Expenditure Caps - (Web) - (PDF)
- Attachment - (PDF)
- 12MA021 - Time Periods for Determining Medicaid Eligibility for Applicants Denied Temporary Assistance - (Web) - (PDF)
- 12MA022 - Supplement to Book 1, LDSS-4148A and Book 2, LDSS-4148B "Important Changes in the Medicaid Program" - (Web) - (PDF)
- Attachment (PDF)
- Attachment - Español (Spanish) (PDF)
- 12MA023 - Assisted Living Program (ALP) Changes Questions and Answers - (Web) - (PDF)
- Attachment - (PDF)
- 12MA024 - Centers for Medicare and Medicaid Services (CMS) approval of Partnership Plan Medicaid Section 1115 Amendment - (Web)
- 12MA025 - 2012 Update to the Actuarial Life Expectancy Table - (Web) - (PDF)
- Attachment - (PDF)
- 12MA026 - Availability of 24-Hour Split-Shift Personal Care Services - (Web) - (PDF)
- 12MA027 - Medical Evidence Gathering for Disability Determinations - Adult Cases - (Web) - (PDF)
- Attachment I - (PDF)
- Attachment II - (PDF)
- Attachment II A - (PDF)
- Attachment III - (PDF)
- Attachment IV - (PDF)
- 12MA028 - Hurricane Sandy - Fee-for-Service Medicaid Processes During the State of Emergency - (Web) - (PDF)
- 12MA029 - Hurricane Sandy - Authorization and Eligibility Verification Processes During the State of Emergency - (Web) - (PDF)
- 12MA030 - Changes to the Family Planning Benefit Program and the Family Planning Extension Program - (Web) - (PDF)
- 12MA031 - Consolidation of Care at Home (CAH) III, IV and VI model waivers into a new 1915(c) waiver known as the OPWDD Care at Home Waiver - (Web) - (PDF)
2011
- 11MA001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2011 - (Web) - (PDF)
- 11MA002 - Chafee Auto Renewal Process - Upstate - (Web) - (PDF)
- 11MA003 - Transmittal Form from Local Departments of Social Services to Child Health Plus - (Web) - (PDF)
- Attachment - (PDF)
- 11MA004 - Treatment of Federal Income Tax Refunds Pursuant to the Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 - (Web) - (PDF)
- 11MA005 - 2011 Federal Poverty Levels - (Web) - (PDF)
- 11MA006 - Medicaid for Kinship Guardianship Assistance Program (KinGAP) Children - (Web) - (PDF)
- 11MA007 - Electronic Signatures on Medicaid Applications - (Web) - (PDF)
- 11MA008 - New Manual Client Notice, OHIP-0052, "Notice of Decision To Pay Third Party Health Insurance Premiums" - (Web) - (PDF)
- 11MA009 - Personal Care Services Changes for Non-Dual Eligible Persons Participating in Mainstream Managed Care Programs - (Web) - (PDF)
- 11MA010 - New Anticipated Future Action Code for Releasees Who Contact the DFR with an Out-of-County Address Change - (Web) - (PDF)
- 11MA011 - Elimination of the Medicare Part D Wrap - (Web) - (PDF)
- 11MA012 - Allowing Reported Changes to Be Treated as a Renewal for Medicaid and Family Health Plus - (Web) - (PDF)
- 11MA013 - Language Identification Tool for Assisting Persons with Limited English Proficiency - (Web) - (PDF)
- Attachment - (PDF)
- 11MA014 - Termination of the TASA (Teen Age Services Act), NBA (Neighborhood Based Alliance), and CONNECT, optional targeted Comprehensive Medicaid Case Management (CMCM) Programs - (Web) - (PDF)
- Attachment - (PDF)
- 11MA015 - Signatures Required on Medicaid Applications and Renewals - (Web) - (PDF)
- 11MA016 - Clarification of the Financial Maintenance Policy - (Web) - (PDF)
- 11MA017 - "Medical Report for MBI-WPD Medical Improvement Group Continuing Disability Review" (DOH-5029) - (Web) - (PDF)
- 11MA018 - Prior Authorization and Payment Requirements for Admission to Out-of-State Non-Specialized Skilled Nursing Facilities - (Web) - (PDF)
- 11MA019 - Production of BICS/CDRs - (Web) - (PDF)
- 11MA020 - Upstate Procedural Changes Related to Incarcerated MA/SSI Recipients - (Web) - (PDF)
- 11MA021 - Increase Medicaid Income Standard for Children Ages Six through Eighteen from 1007#37; FPL to 133% FPL - (Web) - (PDF)
- 11MA022 - Revised "Notice of Decision on your Medicaid Application", OHIP-0053 (formerly DOH-4290) - (Web) - (PDF)
- 11MA023 - Same-Sex Marriage Update Marriage Equality Act - (Web) - (PDF)
- 11MA024 - Medicaid Requirements Regarding Ordering and Referring Physicians - (Web) - (PDF)
- 11MA025 - Managed Care Enrollees with Medicare - (Web) - (PDF)
- 11MA026 - Informational Booklets: LDSS-4148A, LDSS-4148B and LDSS-4148C - (Web) - (PDF)
- 11MA027 - 2012 Medicaid Only Income and Resource Levels - (Web) -
- (PDF)
- Attachment - (PDF)
- 11MA028 - Expanded Definition of Estate Regulations - (Web) - (PDF)
- 11MA029 - OSC Audit - Reminder of Correct Procedures for NAMI Adjustments - (Web) - (PDF)
- 11MA030 - Mass Re-Budgeting Changes and the Auto-Renewal Process - (Web) - (PDF)
2011 (Long Term Care)
- 11LTC001 - Care At Home (CAH) I/II Applications for Children in Receipt of SSI - (Web) - (PDF)
- 11LTC002 - Initial Assisted Living Program Contract and District Responsibility - (Web) - (PDF)
- 11LTC003 - 505.23 Certified Home Health Agency Consensus (CHHA) Regulations - (Web) - (PDF)
- 11LTC004 - Consumer Directed Personal Assistance Program (CDPAP) Services Provided Out of State - (Web) - (PDF)
- 11LTC005 - Revisions to Long Term Home Health Care Program/AIDS Home Care Program (LTHHCP/AHCP) Notices of Decision - (Web) - (PDF)
- 11LTC006 - Uniform Assessment System for New York (UAS-NY) - Computer Readiness Survey - (Web) - (PDF)
- Attachment 1 - UAS-NY Compute Readiness Survey Instructions - (PDF)
- Attachment 2 - Computer Readiness Survey - (PDF)
- 11LTC007 - New State Law Requiring Automatic Change To No More than 8 Hours Per Week of Nutritional and Environmental Support Functions (Level I) For Personal Care and CDPAP Consumers Who Are Authorized to Receive Only Nutritional and Environmental Support Functions - (Web) - (PDF)
- 11LTC008 - Clarifications and Updates to Long Term Home Health Care Program (LTHHCP) 11 OLTC/ADM-1 - (Web) - (PDF)
- 11LTC009 - 2011 Long Term Home Health Care Program Expenditure Caps - (Web) - (PDF)
- Attachment - (PDF)
2010
- 10MA001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2010
- 10MA002 - New York State "Confirmed" Victims of Human Trafficking: Medicaid Implications
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- 10MA003 - Tracking Group II Disability End Dates
- 10MA004 - Randomization of New York State Common Benefit Identification Card Sequence Number
- 10MA005 - Medicaid for Haitians Applying for or Granted Temporary Protected Status by the U.S. Citizenship and Immigration Services (USCIS)
- 10MA006 - Childrenacute;s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and Medicaid - Newborns & Citizenship
- 10MA007 - Family Health Plus Premium Assistance Program Rates Used for Determining Cost Effectiveness
- Attachment A (PDF)
- 10MA008 - Medicare Savings Program Changes in Estate Recovery
- 10MA009 - Enhancements to eMedNY as a Result of the Medicare Modernization Act (MMA) File
- 10MA010 - Medicare Savings Program Household Size
- 10MA011 - Notification to Managed Care Plans of Low Birth Weight Babies
- 10MA012 - Certification of Treatment of an Emergency Medical Condition
- Attachment (PDF)
- 10MA013 - Phasing Out of the Electronic Eligibility Decision Support System (EEDSS)
- 10MA014 - Notice of Medicaid Disability Determination - Revisions
- Attachment (PDF)
- 10MA015 - Processing Medicaid Applications for Children Potentially Eligible for Child Health Plus
- Attachment I Health Plan List (PDF)
- Attachment II Release of Information to the Child Health Plus Program (PDF)
- 10MA016 - Medicaid Extended Coverage - Increased Income Levels
- 10MA017 - Puerto Rican Birth Certificates: Medicaid Applications Received On or After October 1, 2010
- Attachment A - Instruction Sheet (PDF)
- Attachment B - Birth Certificate Application Form (RD-225) English (PDF)
- Attachment C - Birth Certificate Application Form (RD-225) Spanish (PDF)
- 10MA018 - Redesigned Form I-551, Lawful Permanent Resident Card (acute;Green Cardacute;), and Form I-766, Employment Authorization Document and Fee Schedule
- 10MA019 - Medicaid for Haitians Applying for or Granted Temporary Protected Status by the U.S. Citizenship and Immigration Services (USCIS)
- 10MA020 - Changes to MBL for the Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD)
- 10MA021 - Puerto Rico Extends Validity of Birth Certificates
- Attachment A - Instructions for Puerto Rican Born Individuals Applying for New York State Medicaid (PDF)
- Attachment B - CommonWealth of Puerto Rico Department of Health Demographic Registry (PDF)
- Attachment C - CommonWealth of Puerto Rico Department of Health Demographic Registry Español (Spanish) (PDF)
- 10MA022 - LDSS-2831A "Temporary Medicaid Authorization"
- 10MA023 - Revised "Explanation of the Excess Income Programv, OHIP-0026 (formerly the LDSS-4038)
- 10MA024 - Discontinuation of the $25.00 Additional Unemployment Insurance Benefit (UIB) Disregar
- 10MA025 - Increase in the Substantial Home Equity Limit for 2011
- 10MA026 - 2011 SSI, LIF/SCC Medicaid Standard and Medicaid Income and Resource Levels
2010 (Long Term Care)
- 10LTC001 - Long Term Home Health Care Program (LTHHCP) and AIDS Home Care Program (AHCP) Consumer Information Booklet (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- 10LTC002 - Care At Home (CAH) I/II Palliative Care Services (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- Attachment (PDF)
- 10LTC003 - Long Term Home Health Care Program (LTHHCP) Waiver Extension (PDF)
- 10LTC004 - Care At Home (CAH) Case Management Rate Increase (PDF)
- 10LTC005 - Consumer Directed Personal Assistance Program (CDPAP) Documents (PDF)
- 10LTC006 - Physicianacute;s Order for use in the Personal Care Services Program and the Consumer Directed Personal Assistance Program (PDF)
- Attachment (PDF)
- 10LTC007 - Care At Home (CAH) I/II Applications for Children in Receipt of SSI (PDF)
- 10LTC008 - Assisted Living Program (ALP) Model Contract (for use outside of NYC) (PDF)
- 10LTC009 - 2010 Consumer Directed Personal Assistance Program (CDPAP) Implementation Plan (PDF)
- Attachment (PDF)
- 10LTC010 - Prior Authorized State Plan Services and the Department of Health and Human Servicesacute; Office of the Inspector Generalacute;s (HHS OIG) Exclusion Program (PDF)
2009
- 09MA003 - 2009 Federal Poverty Levels, Treatment of the 5.8% Cost of Living Adjustment (COLA) for Medicare Savings Program (MSP) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 09MA004 - Verification of New Address for in County Move (PDF)
- Attachment (PDF)
- 09MA005 - Change in Eligibility for the Office of Mental Health Home and Community-Based Services Waiver (PDF)
- 09MA006 - End-of-Month Coverage on Family Health Plus Case Closings (PDF)
- 09MA007 - Transfer of Assets - Beginning of Increased Look-Back Period, and Coverage Code Changes for Waiver Services (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- Attachment 7 (PDF)
- 09MA008 - Auto-Close Process for Medicare Buy-In (PDF)
- Attachment (PDF)
- 09MA009 - New York State Benefit Identification Card Changes (PDF)
- 09MA010 - District of Fiscal Responsibility Rules for Former Inmates Whose Medicaid is Reinstated (PDF)
- 09MA011 - Discontinuance of DSS-2284, SDX Change Form (PDF)
- Attachment (PDF)
- 09MA012 - Automated Disregard of Additional Unemployment Benefits (UIB) (PDF)
- 09MA013 - Health Insurance Portability & Accountability Act (HIPAA) Privacy Notice Information (PDF)
- 09MA014 - Policy Changes Regarding Verification of Birth Records and Birth Verification Request Letters (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- 09MA015 - Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) Work Requirement: Documentation Change (PDF)
- 09MA016 - Treatment of Automobiles; Elimination of Transfer of Resources Penalty for Single Individuals and Childless Couples (S/CCs) (PDF)
- 09MA017 - Change in Duration of Initial Medicaid Eligibility for Afghan Special Immigrants from Six to Eight Months (PDF)
- 09MA018 - Clarification of Treatment of Additional Unemployment Benefits (UIB) Automated Disregard When There is a Partial Month of UIB Payments Received (PDF)
- 09MA019 - Disability Reviews and Spenddown for Individuals Seeking Treatment of an Emergency Medical Condition (PDF)
- 09MA020 - COBRA Premium Reduction in American Recovery and Reinvestment Act of 2009 (ARRA) (PDF)
- 09MA021 - Elimination of Automated Finger Imaging System (AFIS) Requirement for Medicaid Eligibility (PDF)
- 09MA022 - New Restriction/Exception Code 23 Replaces State/Federal Charge Code for OMH HCBS Waiver for Children and Adolescents with Serious Emotional Disturbance (PDF)
- 09MA023 - Transitional Medical Assistance (PDF)
- 09MA024 - COBRA Premiums and the Family Health Plus Premium Assistance Program (PDF)
- 09MA025 - Financial Status Form (Farm or Business), DOH-4469 (PDF)
- Attachment (PDF)
- 09MA026 - 2010 SSI, LIF/SCC Medicaid Standard and Medicaid Income and Resource Levels (PDF)
- 09MA027 - Elimination of the Resource Test for Non-SSI-Related Medicaid Applicants/Recipients (PDF)
- 09MA028 - USCIS.gov "E-Notification Capability" (PDF)
- 09MA029 - Medicaid Medical Support Transmittal (PDF)
- Attachment (PDF)
2009 (Long Term Care)
- 08OLTC001 - Bridges to Health Waivers (B2H) for Children in Foster Care (PDF)
- 08OLTC002 - Forms and Notices (PDF)
- 08OLTC003 - Nursing Home Transition and Diversion (NHTD) Waiver (PDF)
- 08OLTC004 - New CAH I/II Case Management Agency Selection Forms and Application Cover Sheet Amendment (Attachments) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 08OLTC005 - Consumer Directed Personal Assistance Program: Clarification of 06 OMM/LCM-1, "Questions and Answers Related to Administration of the CDPAP" (PDF)
- 08OLTC006 - Care At Home I/II Waiver Renewal (PDF)
- 08OLTC007 - Non Medical Transportation in the Consumer Directed Personal Assistance Program (PDF)
- 08OLTC008 - Long Term Home Health Care Program Waiver Renewal (PDF)
2008
- 08MA001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2008 (PDF)
- 08MA002 - Spousal Impoverishment Figures for 2008 (PDF)
- 08MA003 - Districts with one Family Health Plus Plan (PDF)
- 08MA004 - Medicaid Buy-In Program for Working People with Disabilities: Eligibility Under the Medicaid Level Substantial Gainful Activity and Trial Work Period Disability Certification (PDF)
- 08MA005 - 2008 Medicaid Only Income Exemption and Resource Levels (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 08MA006 - Treatment of U.S Savings Bonds During the Retention Period (PDF)
- 08MA007 - Family Health Plus: Excepted Benefits (PDF)
- 08MA008 - Economic Stimulus Act of 2008 Digital Converter Boxes (PDF)
- 08MA009 - Revised Desk Guide: "Documentation Guide to Citizenship and Immigrant Eligibility for Health Coverage in New York State" (PDF)
- Attachment (PDF)
- 08MA010 - United States (U.S.) Passport Card (PDF)
- 08MA011 - Family Health Plus Premium Assistance Program Premium Rates for fiscal year 2008-2009 (PDF)
- Attachment (PDF)
- 08MA012 - Special Immigrant Visa (SIV): Iraqi and Afghan Immigrants (Upstate) (PDF)
- 08MA013 - Increase in Medicaid Eligibility Resource Standards; Elimination of Drug/Alcohol Requirement for Medicaid (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 08MA014 - Date of Status (DOS)/ Date Entered Country (DEC) (Upstate) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 08MA015 - Iraqi and Afghan Immigrant Children (Upstate Special Immigrants): Individual Category Code (PDF)
- 08MA016 - Elimination of the Asset Test for the QMB and SLIMB Programs (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 08MA017 - Referrals to Child Health Plus (CHPlus) (PDF)
- 08MA018 - Notice Changes Concerning Long-Term Care Eligibility (PDF)
- 08MA019 - Notice Changes Concerning Transfer of Assets and Medicaid Waiver Applicants/Recipients (PDF)
- 08MA020 - Transfers to Pooled Trusts by Disabled Individuals Age 65 and Over (PDF)
- 08MA021 - Family Health Plus: Pharmacy Carve-Out (PDF)
- 08MA022 - Revised Medicaid Eligibility Income Standards (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 08MA023 - Medicaid Eligibility for Legally Recognized Same-Sex Marriages Performed Elsewhere (PDF)
- 08MA024 - Change in Spousal Budgeting for Individuals in the Traumatic Brain Injury (TBI) Waiver Program (PDF)
- 08MA025 - Medicaid Beneficiary Co-payment Program Changes (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 08MA026 - Policy Change for Individuals Attesting to Zero Resources (PDF)
- 08MA027 - Medicaid Buy-In Program for Working People with Disabilities: Work Requirement (PDF)
- 08MA028 - New York State Enhanced Driveracute;s License (EDL) as Primary Documentation of United States Citizenship (PDF)
- 08MA029 - Refugee Medical Assistance: Eliminating Federal Charge Codes 34, 35 and 36 (PDF)
- 08MA030 - Systematic Alien Verification for Entitlements (SAVE) Program: Price Adjustment Effective October 1, 2008 (PDF)
- 08MA031 - Child Support Enforcement and Medicaid Recoveries (PDF)
- 08MA032 - Enrollment in Medicare Part B (PDF)
- Attachment (PDF)
- 08MA033 - Revised Desk Guide: Key to I-766/I-688B Employment Authorization Documents (EADs) (PDF)
- Attachment (PDF)
- 08MA034 - Family Health Plus Premium Assistance Program: Revised Forms and Guide To Reimburse Co-payments (PDF)
- Attachment 1 (PDF)
- Attachment 1 (Spanish) (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 08MA035 - 2009 SSI, LIF/SCC, and MA Only Income and Resource Levels (PDF)
- 08MA036 - Disability Reviews for Adult Children over 65 (PDF)
- 08MA037 - Discontinuance of Retroactive Aide Category Changes and Disability Determinations for Otherwise Eligible Singles/Childless Couples (PDF)
2008 (Long Term Care)
- 08OLTC001 - Bridges to Health Waivers (B2H) for Children in Foster Care (PDF)
- 08OLTC002 - Forms and Notices (PDF)
- 08OLTC003 - Nursing Home Transition and Diversion (NHTD) Waiver (PDF)
- 08OLTC004 - New CAH I/II Case Management Agency Selection Forms and Application Cover Sheet Amendment (Attachments) (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 08OLTC005 - Consumer Directed Personal Assistance Program: Clarification of 06 OMM/LCM-1, "Questions and Answers Related to Administration of the CDPAP" (PDF)
- 08OLTC006 - Care At Home I/II Waiver Renewal (PDF)
- 08OLTC007 - Non Medical Transportation in the Consumer Directed Personal Assistance Program (PDF)
- 08OLTC008 - Long Term Home Health Care Program Waiver Renewal (PDF)
2007
- 07MA001 - Spousal Impoverishment Figures for 2007 (PDF)
- 07MA002 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2007 (PDF)
- 07MA003 - Empire State Wage Act of 2004 - New York State Minimum Wage (PDF)
- 07MA004 - Technical Amendments To Deficit Reduction Act of 2005 (PDF)
- 07MA005 - Revised Federal Poverty Levels for January 1, 2007 (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- 07MA006 - LDSS-3955 "Certification of Treatment of Emergency Medical Condition" English/Spanish Version (Upstate) (PDF)
- Attachment (PDF)
- 07MA007 - Treatment of Substantial Home Equity for New York State Partnership for Long-Term Care Policyholders (PDF)
- 07MA008 - Prior Approval Nursing for Care At Home Recipients and Care At Home I and II Assessments Attachment (PDF)
- Attachment (PDF)
- 07MA009 - Increase for CAH I & II Monthly Budget Caps, Change in Assessment Interval and Change in Application Cover Sheet (Attachment) (PDF)
- Attachment (PDF)
- 07MA010 - Social Security Number as a Condition of Medicaid Eligibility for Children (PDF)
- 07MA011 - Medicaid Renewal of Home and Community-Based Waiver Participants (PDF)
- 07MA012 - Earned Income Disregard (PDF)
- 07MA013 - Benefits Planning, Assistance and Outreach (BPA&O) for SSA Beneficiaries (PDF)
- 07MA015 - Forms and Notices (PDF)
- Attachment (PDF)
- 07MA016 - CAH Case Management Rate Increase (PDF)
- 07MA017 - Treatment of an Emergency Medical Condition (PDF)
- 07MA018 - Transfer of Assets and Medicaid Waiver Applicants/Recipients (PDF)
- 07MA019 - Evaluating Personal Service Contracts for Medicaid Eligibility (PDF)
- 07MA020 - Treatment of Annuities for New York State Partnership for Long-Term Care Policy/Certificate Holders (PDF)
- 07MA021 - Singles/Childless Couples and Medical Need (PDF)
- 07MA022 - Forms and Notices (PDF)
- Attachment (PDF)
- 07MA023 - Policy Changes Regarding Verification of Birth Records and Birth Certificate Request Letters (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- 07MA024 - Continuing Disability Reviews (PDF)
- 07MA025 - 2008 Medicaid Only Income Exemption and Resource Levels (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 07MA026 - Implementation of the Colorectal and Prostate Cancer Treatment Program (PDF)
- 07MA027 - Elimination of Face-to-Face Interview For Medicare Savings Program (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- 07MA028 - LDSS-2831A "Temporary Medicaid Authorization" (PDF)
- Attachment (PDF)
2006
- 06MA001 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2006 (PDF)
- 06MA002 - Chapter 442 of the Laws 2005 Breach of Information Security (PDF)
- 06MA003 - Medicare Part D and Retiree Health Insurance Benefits, Updates to the DOH Intranet Site (PDF)
- 06MA004 - Treatment of Community Spousesacute; Retirement Funds (PD)
- 06MA005 - Purpose of Medicaid Disability Reviews (PDF)
- 06MA006 - Revised Federal Poverty Levels for January 1, 2006 (PDF)
- Attachment 1A (PDF)
- Attachment 1B (PDF)
- 06MA007 - Earned Income Disregard (EID) (PDF)
- 06MA008 - Medicare Part D Problem Resolution Contacts (PDF)
- 06MA009 - Treatment of Property Contiguous to the Homestead (PDF)
- 06MA010 - Reprinting of Pay-In Reconciliation Reports - April 2005 through December 2005 (PDF)
- 06MA011 - Long Term Home Health Care Program Unique Identifier Code / Restriction Exception Code 30 (PDF)
- 06MA012 - QI-1 Re-enrollment Process Upstate NY; and New Client Notices for Use with the QI-1 Program (PDF)
- 06MA013 - 45 CFR Parts 160, 162 and 164 "U.S. Department of Health and Human Services Office for Civil Rights HIPAA Administrative Simplification Regulation Text" (PDF)
- Attachment (PDF)
- 06MA014 - Chapter 442 of the Laws 2005 Breach of Information Security (PDF)
- 06MA015 - Citizenship Documentation Requirements of The Deficit Reduction Act of 2005 (PDF)
- 06MA016 - Medicaid Long-Term Care Eligibility Changes (PDF)
- 06MA017 - Change in Eligibility Period for the Family Planning Benefit Program (PDF)
- 06MA018 - Recovery of Managed Care Premiums (PDF, 24)
- 06MA019 - Medicaid Long-Term Care Eligibility Changes Videoconference (PDF)
- 06MA020 - Additional Special Medical-Vocational Profile for the Medicaid disability Manual (PDF)
- Attachment (PDF)
- 06MA021 - Citizenship Documentation and Identity Requirements of the Deficit Reduction Act of 2005 (PDF)
- Attachment (PDF)
- 06MA022 - Ahlborn Court Decision - Recovery from a Thrird Party for Medicaid Recipientacute;s Personal Injuries ("104-b liens") (PDF)
- 06MA023 - Forms and Notices Available via the NYS Department of Health (DOH) Intranet Library (PDF)
- 06MA024 - Citizenship Documentation and Identity Requirements of the Deficit Reduction Act of 2005 (PDF)
- 06MA025 - Qualified Provider Training to Determine Medicaid Presumptive Eligibility for Pregnant Women (PDF)
- Attachment (PDF)
- 06MA026 - Reimbursement of Health Insurance Premiums (PDF)
- 06MA027 - Personal Care Services Contracts (PDF)
- 06MA028 - Family Planning Benefit Program (FPBP) Policy Change (PDF)
- 06MA029 - 2007 Medicaid Only Income Exemption and Resource Levels (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- 06MA030 - Respite/Personal Care Clarification (PDF)
- 06MA031 - System Generated Medicaid Managed Care Disenrollment and Auto Reenrollment Process (PDF)
- Attachment (PDF)
2005
- 05MA001 - Clarification of GIS 04 MA /027 Concerning Interest/Dividend Income from Relocation Assistance Payments (PDF)
- 05MA002 - Institutionalized Spousesacute; Social Security Benefits (PDF)
- 05MA003 - Long Term Point of Entry Now On Line (PDF)
- 05MA004 - Start Date for 29 Days of Short-Term Rehabilitation (Attestation of Resources) (PDF)
- 05MA005 - Updated Fair Hearing Language (PDF)
- Attachment 1A (PDF)
- Attachment 1B (PDF)
- Attachment 2A (PDF)
- Attachment 2B (PDF)
- 05MA006 - Medicaid Recipient Co-Payment Program Changes (PDF)
- Attachment 1A (PDF)
- Attachment 1B (PDF)
- Attachment 2A (PDF)
- Attachment 2B (PDF)
- Attachment 3A (PDF)
- Attachment 3B (PDF)
- 05MA007 - Spanish Version of Notification to Pregnant Women for Recovery of Confinement and Pregnancy-related Expenses (PDF)
- Attachment (PDF)
- 05MA008 - Revenue Reimbursement Project: Retroactive FFP Claiming of Certain Inpatient Medical Claims for Inmates of Correctional Facilities (PDF)
- 05MA009 - Manual Renewal Form for Medicaid/Family Health Plus/Child Health Plus A (PDF)
- 05MA010 - Correct Coding of Medicaid Applicant/Recipientsacute; Gender (PDF)
- 05MA011 - Child Health Plus A (Medicaid) Coverage for Children Age Six through Age Eighteen From 133% to 100% of the Federal Poverty Level (PDF)
- 05MA012 - Medicaid Resource Documentation Requirements - Full Coverage (PDF)
- 05MA013 - Revised Poverty Levels for January 1, 2005 (PDF)
- Attachment (PDF)
- 05MA014 - Empire State Wage Act of 2004 - New York State Minimum Wage (PDF)
- 05MA015 - Revised Third Party Data Entry Forms (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 05MA016 - eMedNY Implementation (PDF)
- 05MA017 - eMedNY Third Party Liability Policy Page Unavailable (PDF)
- 05MA018 - eMedNY (PDF)
- 05MA019 - eMedNY (PDF)
- 05MA020 - Office of the Welfare Inspector General (OWIG) Case Review for Recipient Fraud (PDF)
- 05MA021 - Earned Income Disregard (EID) (PDF)
- 05MA022 - Internet Posting of the Medicaid Reference Guide (PDF)
- 05MA023 - 055 OMM/INF-1 Pooled Trusts and Disability Determinations for Indivuals 65 Years of Age and Over (PDF)
- 05MA024 - Medicare Prescription Drug Coverage (PDF)
- Attachments 1 and 2 (PDF)
- 05MA025 - Voided Premium Requests for Duplicate CINS (PDF)
- 05MA026 - Medicaid Recipient Co-Payment Program Changes (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- Attachment 5 (PDF)
- Attachment 6 (PDF)
- 05MA027 - Family Health Plus Resource Test (PDF)
- 05MA028 - Native American Documentation (PDF)
- 05MA029 - Treatment of Clothing as In-kind Income and the Automobile Exemption for SSI-related Applicants/Recipients (PDF)
- 05MA030 - State Home Care Liaison Staffing Changes (PDF)
- 05MA031 - Family Health Plus Resource Test Effective Date (PDF)
- 05MA032 - Mobius Reports (PDF)
- 05MA033 - Applications for the Medicare Savings Programs and Resource Documentation Requirements (PDF)
- 05MA034 - Manual Discontinuance Notices for Recipients with Duplicate Client Identification Numbers (CINs). (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 05MA035 - Internet Update of the Medicaid Disability Manual (PDF)
- 05MA036 - Citizens Displaced by Hurricane Katrina (PDF)
- Attachment (PDF)
- 05MA037 - Long Term Home Health Care Program (LTHHCP) Upstate Fair Hearing Notice Forms (PDF)
- 05MA038 - The Breast and/or Cervical Cancer Treatment Program-Medical Transportation (PDF)
- 05MA039 - Required Tracking of Medicaid-only Recipients Residing in Adult Homes, Enriched Housing Programs and Schools for the Mentally Retarded (PDF)
- 05MA040 - Veterans Nursing Home Per Diem Payments (PDF)
- 05MA041 - Categorical Eligibility for Children in Foster Care (PDF)
- 05MA042 - Discontinuance of Easements for Medicaid and Temporary Assistance Applicants Displaced by Hurricane Katrina (PDF)
- 05MA043 - Care At Home VI Slots (PDF)
- 05MA044 - Medicaid Cap And Managed Care Grants (PDF)
- 05MA045 - 2006 Medicaid Only Income Exemption and Resource Levels (PDF)
- 05MA046 - QI-1 Re-enrollment Process Upstate NY (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 05MA047 - 2006 Reduction in Medicaid Income and Resource Standards for Households of Two (PDF)
- 05MA048 - Individual Categorical Codes for the Medicaid Buy-In program for Working People with Disabilities (MBI-WPD) (PDF)
- 05MA049 - Spousal Impoverishment Figures for 2006 (PDF)
- 05MA050 - Implementation of Congregate Care Level 3, Enhanced Residential Care (PDF)
2004
- 04MA001 - Verdow and Spetz Court Decisions - Availability of Assets Held in Irrevocable Trusts (PDF)
- 04MA002 - Clarification of Nonimmigrant Visa Status (PDF)
- 04MA003 - Revised Desk Guides:
- Attachment 1 - Documentation Guide Immigrant Eligibility for Health Care Coverage in New York State (PDF)
- Attachment 2 - Key to I-766, I-688B, Employment Authorization Documents (EADs) (PDF)
- 04MA004 - Medicaid Buy-In for Working People with Disabilities (MBI-WPD)
- Attachment (PDF)
- 04MA005 - Correction to DMS-1 Clarifications issued on July 1, 2003 (PDF)
- 04MA006 - Retroactive Lump Sum Social Security Benefits (PDF)
- 04MA007 - Medicare Buy-In Action Lists (PDF)
- 04MA008 - Mail Renewal Reminder Letter (PDF)
- 04MA009 - Staged Transition of the Medicaid Buy-In Program for Working People with Disabilities to Local Districts (PDF)
- 04MA010 - Consumer Directed Personal Assistance Program Scope of Services (Revision of GIS 02MA/024) (PDF)
- 04MA011 - Family Planning Benefit Program Fact Sheet (Spanish Translation)
- Attachment 1 (PDF)
- 04MA012 - Discount Drug Card and the State Outreach Toolkit for Medicare (PDF)
- 04MA013 - Medicare Part A Buy-In
- Attachment (PDF)
- 04MA014 - Reporting Immigrant Status and Disclosure of Medicaid Benefits Information (PDF)
- 04MA015 - LDSS-4151A: "Transitional Medical Assistance (TMA) Mailer" (PDF)
- 04MA016 - Revised Desk Guide: Key to I-94 Arrival Departure Record
- Attachment (PDF)
- 04MA017 - Office for the Aging Listening Tours
- Attachment (PDF)
- 04MA018 - LDSS-4151 and 4151A: Transitional Medical Assistance (TMA) Mailer Revision
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- 04MA019 - Family Planning Benefit Program (FPBP) Documents (PDF)
- 04MA020 - Implementation Delay for Resource Attestation (PDF)
- 04MA021 - Renewal Procedures for Family Planning Benefit Program
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 04MA022 - Clarification on the Medicare-Approved Drug Discount Card (PDF)
- 04MA023 - Breast and/or Cervical Cancer Treatment Program (PDF)
- 04MA024 - Disability Awareness Training (PDF)
- 04MA025 - The Medicaid Buy-In For Working People with Disabilities (MBI-WPD) Statewide Conference, " Building Community Partnerships"
- 04MA026 - Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) Monthly Reports and Related Issues (PDF)
- 04MA027 - Interest/Dividend Income Exclusion for SSI-related Applicants/Recipients (PDF)
- 04MA028 - Home Visits for Laboratory Services (PDF)
- 04MA029 - Personal Emergency Response Services (PERS) (PDF)
- 04MA030 - SSI-related Income Resource Changes (PDF)
- 04MA031 - 2005 Medicaid Only Income Exemption and Resource Levels (PDF)
- 04MA032 - Spousal Impoverishment Figures for 2005 (PDF)
- 04MA033 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2005 (PDF)
- 04MA034 - Automated End of Lock-In Notices (PDF)
2003
- 03MA001 - Hospice Care (PDF)
- 03MA002 - HIPAA Privacy Workshop at NYPWA (PDF)
- 03MA003 - Rodriguez v. Novello (PDF)
- 03MA004 - Elimination of the Personal Interview Requirement for Medicaid Renewal (Recertification) (PDF)
- 03MA005 - Immigration and Naturalization Services (INS) Visa Statuses: K, S, T, U, and V (PDF)
- 03MA006 - Revised Federal Poverty Levels for January 1, 2003 (PDF)
- 03MA007 - Introduction of the LDSS4807: "HEALTH CARE PROGRAMS FOR NEW YORKERS" (PDF)
- 03MA008 - Documentation of Social Security Numbers (PDF)
- 03MA009 - Interim Implementation of the Medicaid Buy-In for Working People with Disabilities (MBI-WPD) (PDF)
- 03MA010 - Continuous Coverage for Case Type 13; Case Type 13 to Case Type 20, and Vice Versa (PDF)
- 03MA011 - TEMPORARY PROTECTED STATUS (TPS) (PDF)
- 03MA012 - Spousal Impoverishment Figures for 2003 and Revised "Information Notice to Couples with an Institutionalized Spouse"
and "Spousal Impoverishment Income and Resource Amounts" Chart
- Attachment A (PDF)
- Attachment B (PDF)
- 03MA013 - Medicaid Eligibility for Infants (PDF)
- 03MA014 - Prepaid Mental Health Plans and Nursing Home Care (PDF)
- 03MA015 - Revised Desk Guide "Key to I-766, I-688B, Employment Authorization Documents (EADs)"
- Attachment (PDF)
- 03MA017 - Changes in Medicaid Mail-In Renewal Form (PDF)
- 03MA018 - Mail Order Prescription Plans (PDF)
- 03MA019 - Family Health Plus Reimbursement for Errors and Delays (PDF)
- 03MA020 - Family Health Plus Applicants with Group Based Health Insurance (with no employer contribution) (PDF)
- 03MA021 - Medicaid Budgeting of Married Couples in Congregate Care Level II Facilities (PDF)
- 03MA022 - Payment of State Supplements for SSI Recipients in Nursing Homes and Other Medical Facilities (PDF)
- 03MA023 - Contacting eMedNY Provider Services (PDF)
- 03MA024 - Family Planning Benefit Program Fact Sheet (PDF)
- 03MA025 - Family Health Plus Reimbursement for Errors and Delays
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 03MA026 - 2004 Medicaid Only Income Exemption and Resource Levels (PDF)
- 03MA027 - Spousal Impoverishment Figures for 2004 (PDF)
- 03MA028 - Changes in Fair Hearing Request Telephone Number (PDF)
- 03MA029 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2004 (PDF)
2002
- 02MA001 - District of Fiscal Responsibility for Medical Assistance (PDF)
- 02MA002 - Aliessa, et al. v. Novello - Medicaid Managed Care, Family Health Plus and Spenddown Coverage for Aliens (PDF)
- 02MA003 - Revised Federal Poverty Levels for January 1, 2002 (PDF)
- 02MA004 - Access NY Health Care Application (DOH-4220) (PDF)
- 02MA005 - Revised Language for Medicaid Action of a TA Denial with Separate Medicaid Determination (PDF)
- 02MA006 - District of Fiscal Responsibility for Residents of Certain Adult Care Facilities (PDF)
- 02MA007 - Increase in the SSI Related Student Earned Income Disregard (PDF)
- 02MA008 - Child Health Plus A (Medicaid) Coverage for Children Age Six Through Age Eighteen at 133 Percent of the Federal Poverty Level (PDF)
- 02MA009 - Elimination of the Resource Test for Qualified Individuals (QIs) and Changes to the SLIMB Program (PDF)
- 02MA010 - Changes in the Effective Date of the Elimination of the Resource Test for Qualified Individuals (QIs) (PDF)
- 02MA011 - Clarification of Residency Rules for Residents of Certain Adult Care Facilities (PDF)
- 02MA012 - Continuous Coverage for IV-E Foster Care (PDF)
- 02MA013 - Family Health Plus Program (PDF)
- 02MA014 - Personal Care Services in Emergency Shelters for the Homeless (PDF)
- 02MA015 - Reports of Infant Births over 90 Days Old and State Created Case Numbers for Infants (PDF)
- 02MA016 - Correction to LDSS-4148B: "What You Should Know About Social Services Programs"
- 02MA017 - Family Health Plus Program (PDF)
- 02MA018 - Family Health Plus Program (PDF)
- 02MA019 - Reimbursement of Health Insurance Premium (PDF)
- 02MA020 - Revised Medicare Savings Program Application
- Attachment A (PDF)
- Attachment B (PDF)
- 02MA021 - Child Support Cooperation (PDF)
- 02MA022 - Trafficking Victims Certification Letter (PDF)
- 02MA023 - Use of Undue Financial Hardship Criteria for Transportation Prior Authorization (PDF)
- 02MA024 - Consumer Directed Personal Assistance Program Scope of Services (PDF)
- 02MA025 - Clarification of the Elimination of Resource Test for Qualified Individuals (QIacute;s) and Changes to the SLIMB/QMB Program (PDF)
- 02MA026 - The Family Planning Benefit Program (PDF)
- 02MA027 - Expired Permanent Resident Cards (I-155, I-151) "green cards" (PDF)
- 02MA028 - Protected Health Information (PHI) Disclosures (PDF)
- 02MA029 - 2003 Medicaid Only Income Exemption and Resource Levels (PDF)
- 02MA030 - New Managed Care Recipient Monthly Report (PDF)
- 02MA031 - Qualified Individual Program (QI-2) Termination December 31, 2002 (PDF)
- 02MA032 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2003 (PDF)
- 02MA033 - Family Health Plus Program (PDF)
2001
- 01MA001 - Specified Low Income Medicare Beneficiaries (SLIMB) and Spenddown (PDF)
- 01MA002 - Expiration of Fiscal Assessment Reminder (PDF)
- 01MA003 - Resumption of Transitional Medical Assistance Mailers (PDF)
- 01MA004 - Revenue Reimbursement Project: Retroactive FFP Claiming of Certain Inpatient Medical Claims for Inmates of Correctional Facilities (PDF)
- 01MA005 - Medicaid Eligibility for Infants whose Mothers were Presumptively Eligible (PDF)
- 01MA006 - Transitional Medical Assistance (TMA) Mailers (PDF)
- 01MA007 - Increase in the Threshold Levels of Substantial Gainful Activity and Trial Work Period and the Student Earned Income Disregard (PDF)
- 01MA008 - Recruitment of Managed Care Plans to Provide Family Health Plus/Medicaid Facilitated Enrollment (PDF)
- 01MA009 - Revised Federal Poverty Levels for January 1, 2001 (PDF)
- 01MA010 - How to Reorder the Growing Up Healthy Application (DOH-4133) (PDF)
- 01MA011 - Revision of Family Member Allowance (PDF)
- 01MA012 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2001 (PDF)
- 01MA013 - Procurement of Community Based Organizations to Provide Family Health Plus/Medicaid Facilitated Enrollment for Adults (PDF)
- 01MA014 - Family Health Plus Program (PDF)
- 01MA016 - Medicaid Recoveries When Income and Resources are not used in Determining Eligibility (PDF)
- 01MA017 - Retroactive Federal Financial Participation (FFP) Reimbursement for Inpatient Medical Costs for Involuntarily Confined Individuals (PDF)
- 01MA018 - Clarification of GIS 01 MA/001, "Specified Low-Income Medicare Beneficiaries (SLIMB) and Spenddown" (PDF)
- 01MA019 - Determination of "Good Cause" Not to Bill Health Insurance for Certain Services (PDF)
- 01MA020 - Family Health Plus Training (PDF)
- 01MA021 - Personal Needs Allowance Change for "Institutionalized Spouse" Who Reside in the Community (PDF)
- 01MA022 - Clarification of Medicaid Treatment of Resources for NYS Partnership for Long-Term Care Participants (PDF)
- 01MA023 - System Changes to Support the Family Health Plus Program (PDF)
- 01MA024 - Policy Clarifications Regarding Certain Documentation Requirements (PDF)
- 01MA025 - Aliessa, et al. v. Novello (PDF)
- 01MA026 - Aliessa, et al. v. Novello (PDF)
- Attachment A (PDF)
- Attachment B (PDF)
- Attachment C (PDF)
- 01MA027 - Margaret Murray v. Whalen, et al.
- 01MA028 - Consumer Price Index Error - Medicaid Implications (PDF)
- 01MA029 - Personal Injury and Casualty Action/Gold v. United Health Services Hospital, Inc. (PDF)
- 01MA030 - Aliessa, et al. v. Novello (PDF)
- 01MA031 - DOH Staff - Move to New Location (PDF)
- 01MA032 - Expansion to 133% of the Federal Poverty Level (PDF)
- 01MA033 - (PDF)
- 01MA034 - Medicaid Reference Guide (MRG) on the Web (PDF)
- 01MA035 - New Long Term Home Care Program Fair Hearing Procedures (PDF)
- 01MA035 - Notice of Intent to Deny PCS-Downstate (PDF)
- 01MA035 - Notice of Intent to Deny PCS-Upstate (PDF)
- 01MA035 - Notice of Intent to Discontinue HHAS-Downstate (PDF)
- 01MA035 - Notice of Intent to Discontinue HHAS-Upstate (PDF)
- 01MA035 - Notice of Intent to Reduce PCS-Downstate (PDF)
- 01MA035 - Notice of Intent to Reduce PCS-Upstate (PDF)
- 01MA035 - Notice of Intent to Reduce PT-Downstate (PDF)
- 01MA035 - Notice of Intent to Reduce PT-Upstate (PDF)
- 01MA036 - Federal Ticket to Work and Work Incentive Improvement Act of 1999 (PDF)
- 01MA037 - Evans v. Wing and DeBuono et al. (PDF)
- 01MA038 - Spousal Impoverishment (PDF)
- 01MA039 - Medicaid Implications of the Department of Veteranacute;s Affairs and Railroad Retirement Board Benefitsacute; Adjusments (PDF)
- 01MA040 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2002 (PDF)
- 01MA041 - 2002 Medicaid Only Income Exemption and Resource Levels (PDF)
- 01MA042 - Expansion to 133 Percent of the Federal Poverty Level (PDF)
- 01MA043 - Use of Categorical Codes and Definition of Aid to Families with Dependent Children Due to Unemployment (ADC-U) (PDF)
- 01MA044 - Personal Care Services Regulations and Mayer v. Wing
- 01MA045 - Transmission of OMM Directives (PDF)
- 01MA046 - Correction to LDSS-4148B "What You Should Know About Social Servicesacute; Programs" (PDF)
2000
- 00MA001 - Distribution of Pub. 3360 (12/99): "Need Help Paying for Medical Care?" (PDF)
- 00MA002 - Reminder for Required Information - Evans v. Wing et al. (PDF)
- 00MA003 - Establishing a New Medicaid Model Waiver Program, Care at Home VI (PDF)
- 00MA004 - Medicare Part B Buy-In Auto Close (PDF)
- 00MA005 - Change in Individuals Who Must Comply with Drug and Alcohol Screening Requirements as a Condition of Medicaid Eligibility (PDF)
- 00MA006 - Office of Mental Retardation and Developmental Disabilities (OMRDD) Medicaid Services Coordination (MSC) (PDF)
- 00MA007 - Change in the Definition of Household Size (PDF)
- 00MA008 - Increased Earned Income Disregard from 46% to 47% and Revised 10% Federal Poverty Level Test (PDF)
- 00MA009 - Request for Newborn Project Liaison (PDF)
- 00MA010 - Medication Grant Program - the Need for Cooperation and Coordination between Local Departments of Social Services (LDSS) and Mental Hygiene (DMH) (PDF)
- 00MA011 - Resumption of Medicare Part B Buy-In Premiums (PDF)
- 00MA012 - Earnings from Census Employment for Medicaid Applicants/Recipients (PDF)
- 00MA013 - Correct Address for Submitting Medicaid Claims Received from Out-of-State Medicaid Providers (PDF)
- 00MA014 - Guaranteed 6 Months Coverage Under Medicaid managed Care (PDF)
- 00MA015 - AIDS Health Insurance Program (AHIP) and ADAP Plus Insurance Continuation (APIC) (PDF)
- 00MA016 - LDSS-4148E (S): Supplement to Client Information Books DSS-4148A, 4148B and 4148C (PDF)
- 00MA017 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2000 (PDF)
- 00MA018 - District of Fiscal Responsibility for Individuals Under 21 Years of Age (PDF)
- 00MA019 - Reallocation of Enhanced Funding for Welfare Reform Activities (PDF)
- 00MA020 - Newborn Eligibility and Returned Mail (PDF)
- 00MA021 - Non-Responsible Persons Providing Income to Medicaid Households (PDF)
- 00MA022 - Medicaid Data Confidentiality (PDF)
- 00MA023 - Transitional Medical Assistance Mailer Problem (PDF)
- 00MA024 - New Medicaid Income Eligibility Standard for Pregnant Women and Infants Under the Age of One Year (PDF)
- 00MA025 - 2001 Medicaid Only Income Exemption and Resource Levels (PDF)
- 00MA026 - MBL Mass Rebudgeting and Principal Provider Update Interface (PDF)
- 00MA027 - Treatment of Institutionalized Spousesacute; Social Security Benefits and Requests for Additional Resources (PDF)
- 00MA028 - Medicare Savings Programs and Medicare Premium Payment Programs (PDF)
- 00MA029 - Facilitated Enrollment Transitioning Children (PDF)
- 00MA030 - Spousal Impoverishment: Increase in federal maximum Community Spouse Allowance (CSRA), Family
Member Allowance and Community Spouse Minimum Monthly Maintenance Needs Allowance (MMNA) (PDF)- 00MA031 - HCFA Part B Buy-In Deletions (PDF)
1999
- 99MA001 - Continuing Responsibility of District When Recipient Moves to Another District (PDF)
- 99MA002 - Qualified Individuals Eligible in 1998 (PDF)
- 99MA003 - Second Mailing - Evans v. Wing et al. (PDF)
- 99MA004 - LDSS-4148E: Supplement to Client Information Books DSS-4148A, 4148B, and 4148C (PDF)
- 99MA005 - Fiscal Assessments (Personal Care Services): Best v. Whalen
- 99MA006 - Zebley List of Children Who No Longer Meet the Definition of Disability and Have Exhausted Their Appeal Rights (PDF)
- 99MA007 - Managed Care Guarantee Period and Pharmacy Carve-Out (PDF)
- 99MA008 - Identification of Medicaid and Public Assistance Recipients Mandated into Alcohol and Substance Abuse Treatment (PDF)
- 99MA009 - Care At Home Renewed Waiver Approval (PDF)
- 99MA010 - Task-based Assessment Plans, Rodriguez et al. v. DeBuono and Wing (S.D.N.Y.), Permanent Injunction Issued April 19, 1999 (PDF)
- 99MA011 - Request for Proposals (PDF)
- 99MA012 - Care At Home I Medicaid Model Waiver Program: Establishing A Waiting List (PDF)
- 99MA013 - Stay of Permanent Injunction Order in Rodriguez et al v. DeBuono and Wing (S.D.N.Y.) (PDF)
- 99MA014 - Increase in Level of Substantial Gainful Activity (SGA) to $700 (PDF)
- 99MA015 - Guaranteed Eligibility (PDF)
- 99MA016 - Personal Care, Home Health, Private Duty Nursing Services Management and Fiscal Assessment (PDF)
- 99MA017 - CAP/Medicaid Guarantee Continuation (PDF)
- 99MA018 - Increased Earned Income Disregard from 45% to 46% and Revised 100% Federal Poverty Level Test (PDF)
- 99MA019 - Amended State Version of Federal Form SS-5 "Application For A Social Security Card" (DSS-4000) (PDF)
- 99MA020 - Viagra (PDF)
- 99MA021 - Access to Services (PDF)
- 99MA022 - SSI (Case Type 22) Y2K Date Conversion (PDF)
- 99MA023 - Calvanese v. Calvanese (Personal Injury Settlements) (PDF)
- 99MA024 - Required Information/Screening - Evans v. Wing et al. (PDF)
- 99MA025 - Medicaid Regional Rates for Calculating Transfer Penalty Periods (PDF)
- 99MA026 - Medicaid Disregard of Cash Awards for SSI-related Children (PDF)
- 99MA027 - Outreach Activities for the Medicare Premium Payment Program, QMB, SLMB, QI-1, and QI-2 (PDF)
- 99MA028 - Revision to Categorical Requirements for Aid to Families with Dependent Children Due to Unemployment (PDF)
- 99MA029 - New Medicaid Language to CNS Notice N17 "Failure to Complete the Public Assistance Eligibility Process" (PDF)
- 99MA030 - Enhanced Funding for Implementation of Medicaid Welfare Reform Requirements (PDF)
- 99MA031 - Facilitated Enrollment Grants (PDF)
- 99MA032 - Medicaid Only Income Exemption and Resource Levels (PDF)
- 99MA033 - Review of Nursing Facilities by Contracted Services (PDF)
- 99MA034 - Availability on ELIB of ADMs, LCMs, and INFs issued by the Office of Medicaid Management (PDF)
- 99MA035 - Congregate Care Levels I & II Rates for Rockland County (PDF)
- 99MA036 - Task-based Assessment Plans; Rodriguez v. DeBuono U.S. Second Circuit Decision (PDF)
- 99MA037 - Redetermination of Qualified Individual-1 (QI-1) and Qualified Individual-2 (QI-2) Eligibility and New Fiscal Data for 2000 (PDF)
- 99MA038 - Spousal Impoverishment: Increases in the Federal Maximum Community Spouse Resource Allowance (CSRA), Family Member Allowance, and Community Spouse Minimum Monthly Maintenance Needs Allowance (MMMNA) (PDF)
- 99MA039 - Report on Presumptive Eligibility for Long Term Care Services (PDF)
1998
- 98MA001 - Change in Work Requirements
- 98MA002 - The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA): Effective Dates of SSI Payment and Medicaid Eligibility
- 98MA003 - MBL Correction
- 98MA004 - Medicare Buy-In Transactions
- 98MA005 - Loss of SSI and Medicaid Coverage Relative to Federal HIV Settlement
- 98MA006 - Retraction of Letter to MOMS and PCAPS Regarding Motor Voter Registration
- 98MA007 - Automobile Exemption for SSI-Related Individuals
- 98MA008 - Personal Care and Transportation Prior Approval
- 98MA009 - HIV Confidentiality
- 98MA010 - Qualified Individuals 1 (QI-1acute;s) and Qualified Individuals 2 (QI-2acute;s)
- 98MA011 - Reimbursement of Paid Medical Expenses
- 98MA012 - Accepting Applications for QI-1acute;s and QI-2acute;s - See GIS 98 MA/010
- 98MA013 - Revised Federal Poverty Levels and Family Member Allowance and Increased Earned Income Disregard from 42% to 45%
- 98MA014 - 100% Federal Poverty Level Gross Income Test for LIF Budgeting
- 98MA015 - Golf v. NYSDSS et al., - Court of Appeals Decision
- 98MA016 - Payments to Vietnam Veteransacute; Children with Spina Bifida
- 98MA017 - Treatment of Income and Resources: Netherlands Reparation Payments and Radiation Exposure Compensation Trust Fund Payments
- 98MA018 - Medicare Direct Update on WMS
- 98MA019 - Medicaid Regional Rates for Calculating Penalty Periods
- 98MA020 - DSS Designated Responder for Managed Care/Pharmacy Carveout
- 98MA021 - Newly Enacted State Law Impacting Alien Eligibility for Medicaid
- 98MA022 - Medicare Maximization Policy for Nursing Facility Residents
- 98MA023 - Zebley List of Children Who Lost or Are Expected to Lose SSI
- 98MA024 - Retirement Funds Owned by Medicaid Applicants/Recipients
- 98MA025 - Medicare Premium Payment Program on the Third Party Resourcesacute; Subsystem of WMS
- 98MA026 - Evans v. Wing et al., - Erie County Supreme Court
- 98MA027 - TMA Reason Codes
- 98MA028 - Dual Eligible Enrollment and Outreach Project
- 98MA029 - New York City Department of Social Services v. Spellman - Court of Appeals Decision, 672 N.Y.S.2d 298; 1998
- 98MA030 - Uniform Gifts to Minors Accounts
- 98MA031 - 98 OMM/ADM-3
- 98MA032 - Medicare Buy-In Data Exchange Problem with HCFA
- 98MA033 - CAP Medicaid Guarantee Legislation
- 98MA034 - Earnings From Census Employment
- 98MA035 - Secondary Roster
- 98MA036 - Technical Amendment to Alien Provisions of Welfare Reform
- 98MA037 - Medicaid Only Income Exemption and Resource Levels
- 98MA038 - Spousal Impoverishment: Increases in the Federal Maximum Community Spouse Resource Allowance (CSRA), Family Member Allowance, and Minimum Monthly Maintenance Needs Allowance (MMMNA)
- 98MA039 - Reimbursement Procedures - Correction to Fiscal Reference Manual Pages (Evans v. Wing et al.)
- 98MA040 - Redetermination of Qualified Individual-1 (QI-1) and Qualified Individual-2 (QI-2) Eligibility and New Fiscal Data for 1999
- 98MA041 - Medicaid Eligibility Changes for January 1, 1999
1997
- 97MA001 - Revised Budget Instructions For COBRA And AHIP Children Under 18 Years Of Age
- 97MA002 - Discontinuing Medicare Premium Payments On Buy-In
- 97MA003 - Department Mailing to Dixon Class Members
- 97MA004 - Task-based Assessment Plans, Rodriguez et al. v DeBuono and Wing (S.D.N.Y.)
- 97MA005 - Extension of Federal Financial Participation (FFP) During Medicaid Redeterminations for Individuals with Substance Addiction Disorders
- 97MA006 - Alien Provisions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1997
- 97MA007 - Presumptive Eligibility Video Conference
- 97MA008 - CNS Notice Production/Mailing Problem for Friday, May 23, 1997
- 97MA009 - Principal Provider Entry Adjustment
- 97MA010 - Foster Care Data
- 97MA011 - Conversion of Manual HCBS Waiver Processing to MMIS
- 97MA012 - Claims
- 97MA013 - Redeterminations of Disability for Zebley Children
- 97MA014 - Welfare Reform
- 97MA015 - Medicaid and Welfare Reform
- 97MA016 - Task-based Assessment Plans, Rodriguez et al. v DeBuono and Wing (S.D.N.Y.)
- 97MA017 - Perry vs. Dowling: Recovery of Pregnancy and Birth-related Expenses
- 97MA018 - Community Spousesacute; Otherwise Available Income
- 97MA019 - Alien Provisions of the Welfare Reform Bill
- 97MA020 - Qualified Medicare Beneficiary Program
- 97MA021 - Transition of New York State Veteransacute; Home at Oxford Medicaid Cases to Local District Responsibility
- 97MA022 - Treatment of Certain Settlement Payments
- 97MA023 - Welfare Reform and Case Processing From 11/1/97 to 11/29/97
- 97MA024 - Prior Approval Data Entry Function
- 97MA025 - Change in Procedures for Presumptive Eligibility Providers
- 97MA026 - Suspension of Preliminary Injunction Order in Rodriguez v. DeBuono (Task-Based Assessment Plans)
- 97MA027 - Claims Submission
- 97MA028 - Presumptive Eligibility for Pregnant Women and Residency
- 97MA029 - Upstate Systems Support for Welfare Reform Changes
- 97MA030 - Prior Approval Data Entry Functions
- 97MA031 - Medicaid Only Income Exemption and Resource Levels
- 97MA032 - Certificates of Creditable Coverage
- 97MA033 - Clarifying instructions regarding Mayer v. Wing (S.D.N.Y.,1996)
- 97MA034 - MBL Issues
- 97MA035 - January 1, 1998
- 97MA036 - Prior Approval Information to Local Districts
1996
- 96MA001 - NYPWA Pay-In Workshop and Delayed Telecast
- 96MA002 - Local District Network Evaluation Team
- 96MA003 - NYPWA Pay-In Workshop and Delayed Telecast
- 96MA004 - WMS/Client Notices System Problem
- 96MA005 - Treatment of Retroactive SSD Payments for DA&A Beneficiaries
- 96MA006 - Alien Provisions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1997
- 96MA007 - Prepaid Mental Health Plan (PMHP)
- 96MA008 - Pay-In Subsystem - Terminal Security
- 96MA009 - Community Coverage Option Notices
- 96MA010 - Medicaid Managed Care Grant Funding
- 96MA011 - Evaluated Medicaid Long Term Care Capitation Program Request for Proposal
- 96MA012 - Disabling CNS Codes, E82 and E83
- 96MA013 - Dowd vs. Bane (S.Ct., New York Co.)
- 96MA014 - Revised Federal Disability Criteria for Individuals With Substance Addiction Disorders
- 96MA015 - Revisions to Regulations 360-2.2(f)(1) and 360-2.4(a)(1)
- 96MA016 - Termination of MA: Notification of Discontinuance
- 96MA017 - Medicaid Transportation Policy, Payment, and Authorization Changes
- 96MA018 - MA Regional Rates for Calculating Transfer Penalty Periods Effective January 1, 1996
- 96MA019 - Reductions or discontinuations of personal care services: Mayer et al. v. Wing (S.D.N.Y.), Dowd et al. v. Bane (S.Ct.,N.Y.Co.)
- 96MA020 - Revision to Marketing Materials of Managed Care Organizations (MCOs) Regarding Language Requirements
- 96MA021 - Initial Authorizations for Personal Care Services (Deluca et al. v. Hammons and Wing)
- 96MA022 - Retirement
- 96MA023 - New Notice, Aid-Continuing and Related Procedures Applicable to Hospitalized MA Recipients Who Received Personal Care Services Immediately Prior to Hospitalization (Granato v. Bane; McCoy v. Schimke; Burland v. Dowling)
- 96MA024 - Appeals of Local Department of Social Services Determinations
- 96MA025 - Medicare Part B Premium Change
- 96MA026 - Revised Language Requirements have been Established for Managed Care Organizations (MCOS) with Non-English Speaking Enrollees
(See GIS MA/20)- 96MA027 - Selections for Evaluated Medicaid Long Term Care Capitation Program
- 96MA028 - Railroad Retirement Disability Benefits
- 96MA029 - Dixon, et al. v. Shalala Class Action
- 96MA030 - Inclusion of Pay-In Informational Notice In Client Notices System (CNS)
- 96MA031 - September 3, 1996 Meeting
- 96MA032 - Personal Needs Allowance for Institutionalized Spouses Receiving Home and Community-Based Waivered Services
- 96MA033 - Distribution of Pay-In Transmittals
- 96MA034 - Managed Care Complaint Line
- 96MA035 - Local Department of Social Services Regional Meetings
- 96MA036 - Elimination of Conditional Eligibility Option
- 96MA037 - MA-Only Income Exemption and Resource Levels
- 96MA038 - Client Notice System
- 96MA039 - Notices for New or Changed Excess Income Amounts Due to the COLA
- 96MA040 - MBL Mass Rebudgeting
- 96MA041 - Postal Holiday Effect on the Client Notice System and the Addition of the Suppression Code for PA Denials
- 96MA042 - Poverty Levels and Family Member Allowance
- 96MA043 - Kennedy-Kassebaum Bill, Regarding Transfer of Assets
- 96MA044 - Irrevocable Burial Trusts
Informational Letters (INF)
2023
2021
- 21 INF-01 - Clarification of PRUCOL Status for the Purposes of Medicaid Eligibility (PDF)
2015
- 15 INF-01 - Questions and Answers: Long Term Care Eligibility for MAGI Individuals
2011
2010
- 10 INF-01 - Questions and Answers: Elimination of the Personal Interview Requirement for Medicaid and Family Health Plus Applicants; Revised DOH-4220, Access NY Health Care Application; Release of DOH-4495A, Access NY Supplement A; and Financial Maintenance (PDF)
- 10 INF-02 - Refugee Medical Assistance (RMA) (PDF)
- 10 INF-03 - Medicare Savings Program Enrollment under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) - Frequently Asked Questions (PDF)
- Attachment 1 (PDF)
2009
- 09INF-01 - Medicare Advantage Plans and Medicaid Advantage Plans (PDF)
- 09INF-02 - Revised DOH-4220: ACCESS NY Healthcare Application (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
2008
- 08INF-01 - Citizenship and Identity Documentation Requirements of the Deficit Reduction Act (DRA) of 2005: Final Guidelines (PDF)
- Attachment (PDF)
- 08INF-02 - Social Security Numbers for Immigrants (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- 08INF-03 - Disability Determinations for Medicaid Applicants/Recipients (PDF)
- 08INF-04 - Clarification of PRUCOL Status for the Purposes of Medicaid Eligibility (PDF)
- 08INF-05 - Guide to Accessing Medicaid Private Duty Nursing Services in the Community (PDF)
- Attachment I (PDF)
- 08INF-06 - Family Health Plus Premium Assistance Program: Frequently Asked Questions (PDF)
- Attachment I (PDF)
2007
2006
- 06INF-01 - Revised DOH-420: ACCESS NY Healthcare Application (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- Attachment 3 (PDF)
- Attachment 4 (PDF)
- 06INF-02 - Revision of the LDSS-4807: "HEALTH CARE PROGRAMS FOR NEW YORKERS" (PDF)
- Attachment 1 (PDF)
- 06INF-03 - Notice of Privacy for Foster Care Children (PDF)
- Attachment 1 (PDF)
- Attachment 2 (PDF)
- 06INF-04 - Computer Matching Clarification for Medicaid (PDF)
- Attachment (PDF)
- 06INF-05 - Eligibility for "Federal Medicaid" Based on Immigration Status and Required Documentation (PDF)
2005
- 05INF-01 - Pooled Trusts and Disability Determinations for Individuals 65 years of Age and Over (PDF)
- Attachment (PDF)
- 05INF-02 - Questions and Answers: Resource Attestation (PDF)
- Attachment (PDF)
- 05INF-03 - Questions and Answers, From the March 30, 2005 OMM Teleconference: Changes in Eligibility Levels for Child Health Plus A (PDF)
2003
- 03INF-01 - New Statewide Manual Notice "DOH-4272 NOTICE OF ACCEPTANCE FOR FAMILY HEALTH PLUS" (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- 03INF-02 - Revised DOH-4220: ACCESS NY Healthcare Application (PDF)
- Attachment I (PDF)
- Attachment II (PDF)
- Attachment III (PDF)
- Attachment IV (PDF)
2002
2000
1999
- 99INF-01 - LDSS-4148E: "New Information About Medical Assistance (MEDICAID)," Supplement to Client Information Books DSS-4148A, DSS-4148B and DSS-4148C (PDF)
1998
1996
Local Commissioners Memorandum (LCM)
2023
- 2023 LCM-01 - Administrative Renewals for Family Planning and certain other MAGI cases in the Unwind Period (PDF)
2022
- 2022 LCM-01 - Local District Responsibility for Medicaid Recovery for Residents who receive Medical Assistance through NYSOH (PDF)
2020
- 2020 LCM-01 - New BRMP5520 Report - TPHI (PDF)
- Attachment - BRMP5520 Report Sample (PDF)
2019
- 2019 LCM-01 - Outreach to Assist Medicaid Recipients with Applying for Medicare
- Attachment I - 19 OHIP/LCM-1 - Listing of Facilitated Enrollers (PDF)
- Attachment II - 19 OHIP/LCM-1 - "Apply Today" Postcard (PDF)
- Attachment III - 19 OHIP/LCM-1 - Standard Protocol for Local District and Facilitated Enroller (PDF)
- Attachment IV - 19 OHIP/LCM-1 - Proof of Medicare Application Transmittal & Confirmation Receipt Form (PDF)
- 2019 LCM-02 - Immediate Need for Personal Care Services and Consumer Directed Personal Assistance Program (CDPAP) (PDF)
- 2019 LCM-03 - Health and Recovery Plans (HARP) (PDF)
2018
- 2018 LCM-01 - Clarification: Health and Recovery Plan (HARP) Enrollee Renewal (Recertification) on WMS
- Attachment I - 16 OHIP/LCM-1 – Transitioning MAGI Consumers from WMS to NY State of Health
- 2018 LCM-03 - Transitioning New York City MAGI Consumers from WMS to NY State of Health
- Attachment I - 18 OHIP/LCM-3 – Reason Code 716 (MAGI Individual Transition Medicaid to NY State of Health) (PDF)
- Attachment II - 18 OHIP/LCM-3 – T65 (NY State of Health Invitation Notice Example) (PDF)
- Attachment III - 18 OHIP/LCM-3 –Reason Code 626 (MAGI Fail Renew NYSOH Coverage) (PDF)
- Attachment IV - 18 OHIP/LCM-3 – Reason Code 651 (Discontinue MA Fail to Renew Coverage on NYSOH Multiple Matches and Temporary Accounts) (PDF)
- Attachment V - 18 OHIP/LCM-3 – Reason Code 652 (Discontinue MA Fail to Renew Coverage on NYSOH Matched Accounts (PDF)
2016
- 2016 LCM-01 - Transitioning MAGI Consumers from WMS to NY State of Health
- 2016 LCM-02 - Immediate Need for Personal Care Services and Consumer Directed Personal Assistance Program (CDPAP)
2014
- 2014 LCM-01 - Assisting Veterans in Applying for Veteransacute; Benefits - (Web) - (PDF)
- 2014 LCM-02 - Medicaid Recipients Transferred at Renewal from New York State of Health to Local Departments of Social Services - (Web) - (PDF)
2011
- 2011 OLCM-1 - Personal Care Services Program Assessment Protocols - (Web) - (PDF)
- Attachment 1 - Assessment Information and Training Module (PDF)
- Attachment 2 - Case Note Sample Narratives (PDF)
2008
- 2008 LCM-01 - Continued Medicaid Eligibility for Recipients Who Change Residency (Luberto v. Daines)
1995-1996
Consumer Directed Personal Assistance Program (CDPAP)
- 96 LCM-031 - Rate Codes (PDF)
- 95 LCM-102 (PDF)
Local Districts Social Service Forms
- DOH-4441 - Medicaid Presumptive Eligibility (PE) for Children Screening Form (PDF)
- DOH-5244 - Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (PDF)
- LDSS-3113 - Acknowledgement of Hysterectomy Information (PDF)
- LDSS-3113s - Acknowledgement of Hysterectomy Information (Spanish) (PDF)
- LDSS-3134 - Sterilization Consent Form (PDF)
- LDSS-3134s - Sterilization Consent Form (Spanish) (PDF)
Archive
Older Administratives Directives (ADM)
- 99ADM-5 - Cooperation with Child Support Enforcement for Temporary Assistance, Medicaid, Foster Care and Child Care Services Applicants and Recipients (PDF)
- 95 ADM-11 - Medical Assistance Eligibility for Disabled Adult Children (PDF)
- 95 ADM-05 - SSI Case Correction Procedure: Use of Form SSA-3911 (PDF)
- 89ADM-47 - Treatment of Income and Resources for Institutionalized Spouses/Individuals and Legally Responsible Relatives (PDF)
- 87ADM-40 - Third Party Resources (TPR) Detection and Utilization (PDF)
- 84ADM-21 - Treatment of In Kind Income in the Medical Assistance Program (PDF)
- 82ADM-06 - Implications of the Vailes v. Blum and Mehler v. Blum Court Decisions (with attachments) (PDF)
- 82ADM-05 - Rosenberg v. The City of New York, Blum, et al. (PDF)
- 80ADM-84 - Implementation of Stenson Court Decision (PDF)
- 80ADM-19 - Implementation of U.S. District Court Decision Stenson, et al v. Blum, Bernstein and Califano (PDF)