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UPDATED: JANUARY 2011

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OTHER ELIGIBILITY REQUIREMENTS

STATE AND FEDERAL CHARGES

Description: Generally the cost of any care provided through federally reimbursable (FP) Medicaid is shared by the federal, State and local government at a rate of 50/25/25. Under certain circumstances, the federal and/or State government assumes responsibility for a greater share or the full cost of care provided by the Medicaid program. For example: the federal government is responsible for approximately 50%, the State for about 40% and the local government around 10% of the cost of care provided to recipients of certain long term care services.

Federal charge refers to care fully reimbursed by the federal government; there is no local or State share. State charge refers to care reimbursed by both the federal and State governments or by the State alone. There is no local share in the cost of care provided to a recipient entitled to State or federal charge status.

NOTE: New York State is currently providing Medicaid with federal participation to most recipients, regardless of category. This time limited waiver was granted pursuant to Section 1115 of the Social Security Act.

Policy: The cost of Medicaid may be borne completely by the State government, or it may be shared with the federal and local governments. The cost of care for a specified time period for refugees and Cuban-Haitian entrants is totally reimbursable by the federal government. The cost of care is fully reimbursed by the State and/or federal government for: Native Americans and their families residing on reservations; and individuals who have been patients in an Office of Mental Health (OMH) or Office for People with Developmental Disabilities (OPWDD) facility for five or more continuous years under Chapter 621 of the Law of 1974.

NOTE: The New York State Veteran’s Home at Oxford is a State- operated facility for New York State veterans and their dependents. The State and federal government are financially responsible for veterans and their dependents who are patients at the Oxford Home. Local districts are administratively responsible for determining MA eligibility and processing the eligibility for these A/Rs.

New York State also operates other nursing facilities for veterans. These facilities include the New York City Veteran’s Home at St. Albans, the New York State Veteran’s Home at Batavia and MRG