powered by LeadingAge New York

DOH Announces Annual Updates to Medicaid Criteria for 2021

In recent weeks, the Department of Health (DOH) has posted General Information System (GIS) Messages to local departments of social services (LDSSs) identifying the Medicaid financial levels that will be used to determine eligibility during 2021. GIS 20-MA-013 includes updates of monthly income and resource limitations, community spouse income and resource allowances, Part B premiums, and other financial criteria. An accompanying chart summarizes the 2021 income and resource standards for the non-Modified Adjusted Gross Income (MAGI) population, which includes Medicaid-eligible long term care recipients. GIS 99-MA-002 provides the 2021 Medicaid regional nursing home rates, which are used to calculate a transfer of assets penalty period for coverage of nursing home services.

Importantly, GIS 20-MA-11 updated LDSSs on the continued extension of Medicaid eligibility and enrollment changes made as a result of the COVID-19 outbreak. Under this guidance, Medicaid cases in upstate districts with authorization and coverage dates ending in October, November, and December 2020 and January and February 2021 were systemically extended for 12 months, and individuals will not be required to renew their Medicaid eligibility during the emergency period. Medicaid cases with March 2021 end dates were extended on Dec. 29, 2020. New York City Medicaid cases with authorization and coverage dates ending in October, November, and December were systemically extended for 12 months. Cases with coverage ending in January, February, and March will be extended for 12 months around the 18th of the expiration month.

LeadingAge NY routinely monitors changes in Medicaid eligibility criteria. Member organization staff who routinely deal with Medicaid eligibility issues may also want to consider bookmarking and periodically checking the Library of Official Medicaid Documents page on the DOH website for the most current information.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866