Page 90

UPDATED: JANUARY 2011

531

OTHER ELIGIBILITY REQUIREMENTS STATE RESIDENCE AND RESPONSIBILITY FOR ASSISTANCE

ASSISTANCE TO PERSONS TEMPORARILY ABSENT

Policy: Medicaid may be authorized for a resident of the New York State who is temporarily absent from NYS if the A/R remains in the United States (including Puerto Rico, the Virgin Islands, Northern Mariana Islands, or Guam) or in Canada, and s/he meets one of the following conditions:

(1) the residents of the A/R's district customarily use medical facilities in another state or Canada; or (2) there are limited medical services available in the A/R's local district and the local social services district gives prior approval; or (3) an emergency situation arises.

References: SSL Sect.

62 365

Dept. Reg.

360-3.2(g) 360-3.5

ADM

OMM/ADM 97-1

Interpretation: An A/R is temporarily absent from the State, if before the absence s/he: was a resident of the district; has an intent to return to the State; and has not shown an intent to establish a permanent residence elsewhere.

Residents of New York State may be eligible for Medicaid coverage of medical services provided in another state if residents of the A/R’s district customarily use the medical facilities in another state, or if the type of medical service required is not available in New York State and the local social services district has given prior approval. Medicaid coverage may also be authorized, if while temporarily in another state, the A/R requires emergency medical attention. The assistance of that state is sought in the application process.

NOTE: New York Medicaid will only make payment to out-of-state providers who are enrolled in New York’s Medicaid program. For situations involving medical expenses incurred/paid during the three month period prior to the month of application see OTHER ELIGIBILITY REQUIREMENTS APPLICATION, CERTIFICATION AND RENEWAL NEW APPLICATION.

(MRG)