Effective immediately, the NYS7 Agency designation has been eliminated. As you may know, the NYS7 coding was used in conjunction with issue code 995, Greenstein v. Dowling, to notify Jane McCloskey, formerly from our Department's Counsels' Office and now with the Department of Health, of fair hearing requests and decisions related to reimbursement for out-of-pocket expenses. There is no longer a need to track these cases for Ms. McCloskey's review.
Therefore, fair hearing requests that fit the Greenstein v. Dowling criteria, i.e. issues involving reimbursement for out-of-pocket expenditures incurred by NYC Medical Assistance recipients for covered services as a result of agency error, should be coded as follows:
Agency: NMAP
Category: MA
Subcategory: None
Action: DENY or INAD
Issue Code: 995
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