GIS 14 MA/06:Rescinding GIS 14 MA/01 - Medicaid Eligibility Determinations for Immediate Medical Needs

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director - Director, Division of Eligibility and Marketplace Integration

Subject:Rescinding GIS 14 MA/01 - Medicaid Eligibility Determinations for Immediate Medical Needs

Effective Date: Immediately

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

Effective January 1, 2014, most individuals in a MAGI eligibility category are required to apply for Medicaid through New York State of Health (NYSOH). Currently, NYSOH is not able to issue a Temporary Medicaid Authorization form (LDSS-CS-19/2831A) for individuals who are determined eligible for Medicaid and who have an immediate medical need.

The purpose of General Information System (GIS) message 14 MA/01 was to allow local departments of social services to process Medicaid applications for individuals in a Modified Adjusted Gross Income (MAGI) category of assistance if the individual presented at the local district with an immediate medical need. A number of districts interpreted GIS 14 MA/01 as imposing new requirements with respect to the handling of applications by individuals with an immediate medical need. This was not the Department's intent.

Consequently, the Department has decided to rescind GIS 14 MA/01 effective immediately.

Finally, districts are reminded that, with the exception of Presumptive Eligibility programs, there is no legal authority to provide Medicaid coverage prior to a determination of eligibility.