NYSDOH UPDATES COVID-19 GUIDANCE FOR AUTHORIZATION

On April 8, 2020, the Division of Long Term Care issued an updated version to the March 18 COVID-19 Guidance for the Authorization of Community-Based, Long-Term Services and Supports Covered by Medicaid. Despite consumers going without services and personal assistants falling ill, the Department still requires that new personal assistants undergo health assessments, immunizations and tuberculosis tests before they can work. 

This guidance covers four areas relevant to CDPA:

1. Physician’s orders: Initial medical assessments for CDPA and personal care are still required but may be done via telehealth.

2. Initial Community Health Assessments: Still required but may be done via telehealth. MLTC enrollment eligibility criteria remains unchanged.

3. Community Health Reassessments: 6-month recertification assessments are suspended.

4. Annual Health Assessments for Personal Assistants: Initial health assessment, including TB test and vaccines, are required, but annual requirement for current PAs is waived. 

5. Facility Assessments: Grants facility directors of nursing homes/other facilities discretion to permit only “medically necessary” visits, per Executive Order 202.1.

EVV DEADLINE DELAYED TO JANUARY 1, 2021

The deadline for EVV implementation is now January 1, 2021 for Personal Care Services and CDPA.

The New York State Department of Health’s Electronic Visit Verification (EVV) Good Faith Effort (GFE) exemption request has been approved by the Centers for Medicare and Medicaid Services (CMS), delaying the required implementation date for EVV to January 1, 2021 for Personal Care Services (PCS).

To view the CMS approval letter for New York State click here. To learn more about the NY Medicaid EVV Program please visit the website at: https://health.ny.gov/health_care/medicaid/redesign/evv/.

The 21st Century Cures Act is a federal law, passed by Congress in December 2016, that in part requires all state Medicaid programs to implement an EVV system for personal care services (PCS) and home health care services (HHCS). All states must implement an EVV system to avoid a reduction in federal Medicaid funding. For more information on the federal law and requirements for EVV, visit: www.Medicaid.gov.

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