NYSDOH Releases New Community Based Long Term Care/CDPA Policy Documents
Click here for MLTC Policy 13.15: Refining the Definition of Community Based Long Term Care Services refines the definition of who is considered to be in receipt of community based long term care. Specifically, it exempts those who are in receipt of personal care for only Level 1 services, such as housekeeping, nutrition services and the like. The document notes that, upon reassessment by plans, any individuals in receipt of only Level 1 services should be disenrolled and returned to FFS.
Click here for MLTC Policy 13.16: Questions and Answers Further Clarifying the Definition of Community Based Long Term Care Services is meant to provide further clarity to MLTC Policy 13.15. Of note to FIs and recipients of CDPA, this document notes that MLTC Policy 13.15 applies to CDPA recipients who are in receipt of only Level 1 services. It goes on to note that because CDPA services are bundled, it is impossible to screen CDPA recipients in advance for mandatory MLTC. They note that, on assessment, CDPA enrollees should be disenrolled from MLTC if they are only in receipt of, or found to be only in need of, Level 1 services.