Information for Managed Care/Managed Long Term Care Plans

Consumer Directed Personal Assistance (CDPA) is an alternative to traditional home care that is available to all Medicaid-eligible individuals authorized to receive personal care, home health or skilled nursing services.  Consumers using CDPA schedule their own hours and hire their own personal assistants, lowering unmet need associated with traditional models and lowering costs associated with the coordination of complex schedules between nurses, home health aides and personal care aides.

For those unfamiliar with the program, it will be helpful to review the regulations and procedures of the program.  CDPAANYS is glad to assist with any questions that may arise.

Click here for the NYSDOH Office of Health Insurance Programs’ Directive on the Scope and Procedures of CDPA.

Click here for current, unabridged CDPA regulations (While most of the regulations are included in managed care contracts, the regulations in 505.28 only apply to Fee for Service CDPA).

 

Effective November 1, 2012, Consumer Directed Personal Assistance (CDPA) is included in the “benefit package” for both Mainstream Medicaid Managed Care and Managed Long Term Care. This change affects both people who have Medicaid only and people who have both Medicaid and Medicare (“dual eligibles”). It is the responsibility of the plan to offer information about how to quality for CDPA or other community-based long term care services as an option to all members who request personal care or home care services.  Plans are also responsible for providing written educational materials to members/designated representatives who express an interest in CDPA.

Mandatory Managed Long Term Care (MLTC) enrollment will spread across New York State in a series of phases beginning in New York City in November 2012.

Click here for a detailed schedule of mandatory MLTC roll-out dates.

The New York State Department of Health Medicaid Redesign Team worked with CDPAANYS to draft a series of final documents for the transition of CDPA.

Click here to access the NYSDOH Medicaid Redesign Team page.  Scroll down to MRT 90 – MLTC and then to CDPAS Final MLTC Documents (posted around 10/1/12).

Click here for the Responsibilities of the Health Plan and Consumer.

Click here for the Policy for the Transition of CDPA into Managed Care.

Click here for the Administrative Agreement for the Provision of Fiscal Intermediary Services for CDPA.