Notice to Homeless Shelter Operators Concerning Mandatory Medicaid Managed Care
Some shelter residents will receive packets from New York Medicaid CHOICE containing notices that they have been scheduled for mandatory enrollment into Medicaid managed care plans.
Despite these notices, no resident of a homeless shelter in NYC is required to join - they are entitled to an exemption from the program.
All homeless individuals in NYC, including residents in DHS shelters, contracted and private shelters, and street homeless individuals are exempt and are not required to join a managed care plan.
You can assist your residents to obtain an exemption as follows:
- • If a New York Medicaid CHOICE envelope arrives for a person who has moved out of your shelter, PLEASE DO NOT FORWARD THE ENVELOPE -- RETURN TO THE SENDER. New York Medicaid CHOICE stops the auto assignment process for any Medicaid recipient whose mail is returned.
- • ·You can explain to your residents who receive a Medicaid CHOICE envelope that they do not have to join a health plan unless they want to.
- • You can assist the residents who receive a Medicaid CHOICE envelope to complete the necessary request for an exemption, as follows:
- Upon request, New York Medicaid CHOICE can send shelter Directors a packet of exemption ("form 1") request forms. You can assist the client to fill out one of these forms, which they must sign.
- You can complete a letter from your shelter on letterhead stationery to demonstrate that the recipient is a resident of your shelter--this letter will accompany the request. (See model letter below)
- oYou can assist the client in mailing the exemption request to New York Medicaid CHOICE at the address listed on the exemption forms and the model letter.
- You can assist the client to call New York Medicaid CHOICE at 1-800-505-5678, for further information or assistance.
Disenrollment Policy
Expedited Disenrollments: All homeless shelter residents who wish to disenroll from their managed care plan will now be offered an expedited disenrollment.
- • This means that disenrollments will generally be processed within two business days from receipt of the client's request.
Forms for Expedited Disenrollments: The homeless exemption form will result in an expedited disenrollment for shelter residents; it is not necessary to specifically request expedited disenrollment or use a special form.
- • Shelters may obtain batches of blank exemption forms from the Mail house Coordinator at New York Medicaid CHOICE, Telephone Number: 917-228-5600.
- • Shelters may also obtain exemption forms by fax, by calling New York Medicaid CHOICE at 1-800-505-5678.
Documentation of homeless status: If the resident is included in the database of shelter residents used by New York Medicaid CHOICE, it is not necessary for your facility to send a letter attesting to their residency status - the member simply has to file an exemption request. Consumers can call New York Medicaid CHOICE at 1-800-505-5678 to verify if their residency status has been recorded on its database. However, if the resident is not listed in the database, a brief letter must accompany the exemption request on behalf of the shelter resident from his homeless facility. (See model letter below). This letter, in addition to the exemption form, should be provided as evidence of their residence so that their disenrollment can be expedited.
Representation: Homeless clients may designate another person such as a caseworker to represent them or assist them in contacting New York Medicaid CHOICE.
For further information or to request training, contact the Bureau of Managed Care at the division of Health Care Access and Improvement at the New York City Department of Health & Mental Hygiene, at 311.
NOTE: Please do not send in exemption requests for residents who have not yet received their mandatory envelope from New York Medicaid CHOICE---these requests will not be processed.
