GIS 11 MA/015: Signatures Required on Medicaid Applications and Renewals

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director Division of Coverage and Enrollment

Subject: Signatures Required on Medicaid Applications and Renewals

Effective Date: September 1, 2011

Contact Person: Local District Support Unit: Upstate (518)474-8887, NYC (212)417-4500

The purpose of this General Information System (GIS) message is to advise local departments of social services (LDSS) of the policy regarding required signatures on Medicaid/Family Health Plus (FHPlus) applications and renewals.

Currently, signatures are required at application and renewal for all adults applying for Medicaid/FHPlus. Effective September 1, 2011, only the signature of one applying adult will be required at renewal. If an adult is requesting to be added to a Medicaid case at renewal, his/her signature is required.

As a reminder, if the renewal is for a child(ren) only, the legally responsible relative or caretaker relative may sign the renewal. When a child under 21 is applying or renewing for him/herself, he/she can sign the application or renewal form.

Please direct any questions to your local district liaison.