Trainees can locate and enroll in courses through the training calendar page on this website.

Trainees will receive a new user email from the Absorb system containing a password reset link and username information. Please keep this information in a safe place, as you will be using the same credentials for all trainings.

• Webinars are recorded seminars or video conferences viewed on-line according to a pre-scheduled date and time. They do not require a trainee to be on-site at a special location, so the trainee can view webinars from their own computer.

• Instructor-led trainings are interactive classroom sessions with a live trainer who facilitates and educates on the learning opportunity.

• Computer based trainings (CBTs) are on-line, self-paced, interactive learning opportunities.

Yes, all course resources will be available to you after you attend a class, located within the specific class in your Absorb My Courses tile.

• If you need to cancel or disenroll from a training course, please contact MAXIMUS at 1-855-945-2830 or send us an email at TravelandTrain@maximus.com.
• For cancellations or changes less than one week before a scheduled training, please call the Travel Coordinator directly at 1-855-945-2830.

You can reset your password by clicking here. You will need your username (which is the email address you used to register in Absorb). Please be sure to check your spam folder for your reset link.

You may email us at TravelandTrain@maximus.com. Or call us at 1-855-945-2830 Monday-Friday 8:00am-5:00pm, with an option to leave a voicemail message after hours. We have dedicated representatives who can help answer all your questions.

Each time you may need to travel, book your travel in two easy steps:

1. Upon enrolling in an instructor-led course, you will receive a travel survey that will determine your eligibility for hotel accommodations. If hotel accommodations are requested, you will receive a second survey asking for more details. You will need to complete this survey for every course that may require travel.
2. If eligible for hotel accommodations, you’re all set. A MAXIMUS Travel Coordinator will arrange for hotel accommodations at or near the training site and will send you a confirmation email.

If driving your own vehicle and you are eligible for mileage reimbursement (as determined by the travel survey), the MAXIMUS trainer will confirm your originating address at the training and hand you a reimbursement form. Upon securing your supervisor signature, scan and send your signed form and any parking/toll receipts to TravelandTrain@maximus.com. Please be sure to include your name and the class you attended.

Effective April 1, 2022, the State On Line Query (SOLQ), may be used to access Social Security Income information and Medicare eligibility information for purposes of determining eligibility for Medicare Savings Plan (MSP) applications and renewals. Please continue to follow all SOLQ guidelines (attached) for accessing information for purposes of determining Medicaid or MSP eligibility.

The main scenarios are clients in the MBI-WPD program and those with full Medicaid under MAGI-like budgeting who have income above the SLMB level. Since clients in these scenarios cannot have full Medicaid and QI, they are given full Medicaid coverage and MIPP reimbursement. Also, there are clients who need a partial MIPP to reimburse them up to the MA level. Additionally, LDSS staff will see recipients being referred from NYSOH to the district who are in receipt of MIPP. These clients may be eligible for MSP going forward at the district but would be receiving MIPP at the time of referral. 
Additionally, LDSS staff will see recipients who are being referred from NYSOH to the District who are in receipt of MIPP. These clients may be eligible for MSP going forward at District but would be receiving MIPP at the time of referral.

QMB starts the month after the month of determination.

No. While the instances of paying for Part A on a non-M HIC client are rare, they do occur.

No, while the file contains a dollar amount for income, it does not show the frequency at which the income is received and the income frequency on the file can vary.

When a client resides in a Congregate Care Facility. An individual who does not qualify for QMB may be enrolled in the Medicare Buy-In through a different path (if he or she qualifies) but it is all the Medicare Buy-In.

Effective April 1,2022, the State On Line Query (SOLQ), may be used to access Social Security Income information and Medicare eligibility information for purposes of determining eligibility for Medicare Savings Plan (MSP) applications and renewals. Please continue to follow all SOLQ guidelines (attached) for accessing information for purposes of determining Medicaid or MSP eligibility.

Through taxes paid, FICA and Medicare. The only difference is, they pay the entire cost, not just the employee cost.

HC is still required for MBI, so it is left as open.

Yes

Transportation expenses can be applied toward a spenddown liability if the transportation was to and/or from a medically necessary appointment. Proof that the recipient attended the appointment, including date and time (could be written by the provider) is required, as well as receipts for any tolls, parking, and bridges. In order to apply the cost of mileage, a map with trip mileage between the recipient’s home and the medical appointment is also required. Current reimbursement rates established by the IRS should be used when calculating mileage costs.

In general, unless the district has a reason to question the bills, over-the-counter receipts are sufficient documentation.

Paid expenses are “anchored”/deducted from the income in the accounting period in which it is paid. Exception: An exception is made for expenses incurred and paid in the three-month retroactive period. When no part of the retroactive period is included in the first prospective accounting period, expenses incurred and paid during the retroactive period, which have not been used previously to establish eligibility can be deducted from income in the first prospective accounting period.

Per NYS SSL, Part 365-a “Medically necessary medical, dental and remedial care, services and supplies, as authorized in this title or the regulations of the department, which are necessary to prevent, diagnose, correct, or cure conditions in the person that cause acute suffering, endanger life, result in illness or infirmity, interfere with such person's capacity for normal activity, or threaten some significant handicap and which are furnished an eligible person in accordance with this title and the regulations of the department.”

Yes, whether the individual presents a script or purchases it over the counter, the cost can be applied toward a spenddown liability.

Yes, along with a note from the treating physician indicating medical need.

In general, over-the-counter medications can be considered medically necessary; unless the individual is presenting receipts for medicine that is much more than one individual could use safely and according to instructions on the label or directed by a physician.

Generally, the policyholder should be the one receiving the HIPP payment (which is DOH preference). Occasionally the employer can be paid if they will accept payment.

No, you should always verify with the employer how many premium deductions per year to determine the yearly premium and divide that by 12 months to get the monthly premium.

There is not a cost effectiveness test for Part C, a Buy-In determination must be done.

It will update in eMedNY, but the payee address must be updated manually.

For MIPP, only the consumer can be reimbursed. For HIPP, generally the policyholder would be reimbursed unless the employer will accept reimbursement and not charge the policyholder up front. Insurance provider can also be reimbursed, in rare cases.

590b tables are always used for married couples.

No, a non-applying or an ineligible spouse is not required to maximize his or her retirement account.

No, all retirement funds must be evaluated for penalty free periodic payments or principal even if the A/R is below the resource allowance.

Maximum payments would be based on life expectancy using the current life expectancy tables.

Any action by the individual that changes the course of payment from the annuity or that changes the treatment of income or principal of the annuity.

The Deficit Reduction Act (DRA) of 2/8/06

Large lump sum payment scheduled at the end of a series of considerably smaller periodic payments.

The beneficiary is the only thing that can be changed.

No, only if the wording is “must or shall”.

The individual, parent, grandparent, legal guardian of the individual or a court.

No income contribution to an exception trust cannot be excluded if individual is subject to chronic care post eligibility.

A bypass trust is one that might be used for wealth planning by spouses to preserve an estate tax exemption. Regardless of the type of trust, the terms of any trust must be reviewed in accordance with Medicaid rules to determine if the provisions of the trust have an impact on Medicaid eligibility. Districts should contact their LDSS attorney or Local District Liaison for guidance with any specific questions or cases.

A Medicaid beneficiary with an exception trust (a “special needs trust” or “supplemental needs trust”) who is no longer disabled as that term is defined under Section 1614(a)(3) of the Social Security Act is no longer entitled to have exception trust assets disregarded under Medicaid rules. If the terms of the trust call for the trust to be terminated should the individual no longer meet the required disability criteria, the payback requirement is triggered and the Medicaid program must first be repaid from the trust assets up to the amount of Medicaid paid before remaining trust assets are distributed under the termination. Districts are reminded to seek guidance from their LDSS attorney on such issues, and may also contact their Local District Liaison for guidance with specific cases - this response is not meant to direct an outcome in an actual case given full case details that the LDSS must review, which are not presented in the question here. It is also important to remember that many disabled individuals work and the fact that a certified disabled individual is working does not in and of itself render that individual no longer disabled as defined under Section 1614(a)(3) of the Social Security Act. In addition, Medicaid rules are applied uniformly regardless of the amount of assets in a trust.

Yes, when there is only one CIN found even if it was only used in NYSOH the LDSS should use it.

No, the EEC code M is the only one that should be used.

Per the Luberto LCM from 2008 that states, “If a recipient advises the district of a move, in advance of his or her actual relocation, the district is responsible for providing coverage through the month of actual move and the following month.” Generally, though, the closing in the previous county should be the transaction month plus one day (so it begins the first day of the following month). The new county should be putting up the enrollment if the same plan is present, and no A/R selection is required. If the A/R does need to make a choice, however, the new county should do outreach. Oftentimes, the county relies on Maximus for this, but Maximus will not catch that a new enrollment is needed until the day there is no enrollment in the system, so it results in a gap in enrollment.

Income changes should be stored if rendering ineligible.

No, the only exempt waiver populations are OPWDD, TBI and NHTD. Children’s waiver is mandatory.

Respite care falls under hospice per Appendix K of the MMC Model Contract. MMC covers hospice for A/Rs that are already enrolled, but if the A/R is newly applying, then hospice would be an exclusion and they could not enroll.

Medicare is paid through taxes paid, FICA and Medicare. The only difference is, they pay the entire cost, not just the employee cost.

Effective April 1,2022, the State On Line Query (SOLQ), may be used to access Social Security Income information and Medicare eligibility information for purposes of determining eligibility for Medicare Savings (MSP) applications and renewals. Please continue to follow all SOLQ guidelines (attached) for accessing information for purposes of determing Medicaid or MSP eligibility.

HC is still required for MBI, so it is left as open.

No. Verification of the impediment should be in the form of a written letter/statement from the individual (s) who owns the property jointly with the Applicant/Recipient. The letter/statement does not require notarization. Districts are reminded to consult their LDSS attorney or Local District Liaison for guidance with any specific questions or cases on this subject.

If the payment is for HIPP, the client can refuse the reimbursement, however, if it is cost effective, they must enroll in the coverage. If the payment is for MIPP, the client must enroll in Medicare if eligible. If the client is eligible, the MIPP payment must be processed. The client can refuse to cash the check.

Yes, there is a limit to the notes, however in eMedNY if you right click on the notes it has historic records as to what was changed. If space is needed, simply delete from the oldest notes in the record (Not entire note, but enough to make room to add the new note) and then save and then the system should allow the entry of the additional notes.

This answer would depend on the Category of eligibility prior to the QMB determination and if the person is fully Medicaid eligible. It also would depend on if they were eligible based on a spenddown. Therefore, this may be something that they would consult with DOH TPL if and when the situation arises.

The payee is determined based on who pays the premium and whether or not a carrier/employer/union will accept payment on behalf of the recipient. In most cases, these other entities will not accept payment directly from NYS.

Currently we do not remove/archive any pay lines to our knowledge. This allows us to view and follow all MIPP payments made to a client. In researching information, the pay lines are often reviewed. As for answering if they are “cleaned” up, that still is not clear, but if the question is do we archive them on a scheduled basis, they are not currently archived.

The cost of life alert cannot be used towards a spenddown liability.

Witch hazel products are considered herbal remedies. The cost of CBD Epidiolex is approved for treating rare forms of epilepsy.

Air conditioners are not medical equipment, so the cost of such cannot be applied toward a spenddown liability.

The reconciliation process is limited to the Pay-In Program. There is nothing to reconcile if an individual’s spenddown is met by applying paid or incurred bills.

The liners would be considered a filter and cannot be applied toward a spenddown liability.