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covid-19 medicaid update

IMPORTANT COVID-19 UPDATE: Changes to Medicaid Application Process during the COVID-19 Pandemic

A recently issued General Information System message (GIS) from the New York State Department of Health (which can be found here: https://www.health.ny.gov/health_care/medicaid/publications/docs/gis/20ma04.pdf) implements new and sweeping changes to the Medicaid application process. According to the GIS, these procedures will be in place “for the duration of the COVID-19 public health emergency”.

Here is a brief summary of some of these important changes:

Recertifications

There will be no need to recertify during the emergency period. All active Medicaid cases with coverage dates ending in March, April, May or June will be automatically extended for 12 months. If you submit or have already submitted, a recertification, it is not required to be processed at this time. Medicaid coverage in effect as of March 18, 2020, must remain in effect during the emergency period and cannot be terminated or decreased.

Medicaid Applications

The Department of Social Services (DSS) must allow for self-attestation for all eligibility criteria, except for citizenship/identity. This means that an applicant will not have to submit financial statements and related information as part of the application. A completed Medicaid application, including the Supplement A, must still be completed.

For a nursing home application, the same rule applies and the applicant can attest as to income and resources and as to any transfers during the look-back period.

Additionally, during this emergency period, for individuals in hospitals and nursing homes, the application can be signed by someone on behalf of the applicant. This addresses the inability in large part to be able to meet with people in those settings as a result of the pandemic.

If information is missing or needed, DSS should contact the applicant or the applicant’s representative (or whoever signed the application) by telephone or email for the missing information.  There will be no immediate need to supply documentation and the information can be provided verbally.

Conditions of Eligibility

The following conditions are being waived during this time:

  • Individuals turning 65 must not be required to apply for other benefits (ie, Medicare and Social Security) as a condition of eligibility
  • The applicant will not have to apply for VA benefits, as applicable
  • For retirement accounts, DSS may accept attestation as to the amounts being received

These broad and sweeping (temporary) revisions to the Medicaid application process are a welcome change to those who are in need of Medicaid currently and to those who want to ensure uninterrupted Medicaid eligibility and services.

It is important to note that these revisions are temporary in nature and we expect further relevant updates in the future.

If you or a loved one are in need of help at home, or in a nursing home, it is critical to move quickly to get started and contact an experienced elder law attorney to assist you with the process.

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