DOH clarifies process of becoming an FI

Consumer Directed Personal Assistance is growing…fast.  This fact has not gone unnoticed by many in the field and CDPAANYS receives numerous questions about how agencies can become a Fiscal Intermediary and offer CDPA.  In an effort to provide clarification, CDPAANYS sought specific guidance from the Department of Health.  We were pointed to a 2006 Questions and Answers document that we are informed is still in effect.

The document, entitled Consumer Directed Personal Assistance Program (CDPAP) Questions and Answers 2006 and available on the Department’s MRT website, details the process as follows:

13.    Q.  How does an individual or agency become a CDPAP Fiscal Intermediary?

 A.  The initial step in the process is to contact the local department of social services (LDSS) in order to determine whether or not the LDSS wants to pursue a contract/memorandum of understanding (MOU) with the individual or the agency. If the LDSS determines that they wish to pursue a contract/MOU with the entity, they must follow the guidelines delineated in 98 OCC LCM-003. The agency/individual must contact the Bureau of Long Term Care Reimbursement at (518) 474-1057. A Health Provider Network (HPN) account will be established. The HPN can be contacted at 518-473-1809 (ask for Commerce Trainers). The agency/individual will access their HPN and complete the required cost report(s) in order to establish rates. If the agency/individual is not already a Medicaid provider, they must also contact the Division of OHIP Operations, Bureau of Provider Enrollment at (518) 473-6075 in order for the Department to establish a provider ID number.

We were informed that the phone numbers may not be valid anymore.  However, contact information for all Department of Health divisions can be obtained from their website at health.ny.gov.
To reinforce, the steps, as outlined by the Department of Health, are:
  1. If you are not already enrolled as a Medicaid provider, contact the Bureau of Provider Enrollment to become one.
  2. Obtain a contract with a Local Department of Social Services.
  3. Contact the Bureau of Long Term Care Reimbursement to establish a Health Provider Network account and complete required cost reports to establish a rate.

It is important to note that DOH maintains that these steps must be followed BEFORE an entity may enter into an Administrative Agreement to Provide Fiscal Intermediary Services with a managed care or managed long term care company.  

CDPAANYS recognizes the difficulty that contracting with LDSS’s will pose to individuals and agencies that are wishing to begin offering CDPA services.  Therefore, we are actively advocating for the creation of a certification process that will allow a more streamlined process for becoming a FI.

 

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