In an effort to ensure that only eligible persons receive Medicaid, a pilot program has been initiated under the joint control of the New York City Human Resources Administration (NYC HRA) Medical Assistance Program (MAP), Eligibility Verification Review (EVR), and the Office of Revenue Investigation (ORI), entitled the MAP/EVR Jamaica New York Community Care Medicaid Pilot.
Non-Public Assistance applicants for Medical Assistance (MA-Only), other than pregnant teens meeting Medicaid eligibility requirements, will be referred for Eligibility Verification Review (EVR) home visits. Program investigators will conduct home interviews and will submit case recommendations to the Medicaid site. The Medical Assistance Program (MAP) is responsible for the accuracy of the final determination.
We have started to receive MA denial notices subsequent to the Eligibility Verification Review. Although we have been advised that these notices would be clearly stamped "EVR", a notice may not have been stamped or only one page of the notice may have been stamped; therefore, you should consider any MA denial notice that refers to "Eligibility Verification Review" as part of this initiative. The proper coding for these notices is:
Agency: NMEV/NMAP
Subcategory: None
Category: MA
Action: Deny
Issue Code: Appropriate MA Code
Aid Status: NA
Hearing Site: 330 W. 34th Street
Proper coding of these cases will ensure notification to the Medical Assistance Program as well as Curtis Tibbs, the contact for the Medicaid Eligibility Verification Review initiative.
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