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ADHC Unbundled Services Payment Option Regulations Published in State Register

The proposed Part 425 regulations for the adult day health care unbundled services/payment option were published on June 11 in the State Register. These are the proposed regulations formerly known as the hybrid option regulations, which were first published in Aug. 2013. The comment period on the proposed regulations is 30 days.

Click here to view the entire June 11 issue of the Register. The material on ADHC regulations can be found on pgs. 12-14. You may also review the entire text of the proposed regulations by clicking here.

The revised rule making on the proposed ADHC regulations make it clear that the purpose of the regulations is to allow ADHC programs to work more effectively with Managed Long Term Care (MLTC) plans. Use of the unbundled services/payment option is voluntary on the part of an ADHC program. Programs will be able to utilize the option by providing the Department of Health (DOH) with 30 days written notice.

As originally proposed by the ADHCC, programs that utilized the unbundled services/payment option would have been allowed to admit up to 30 percent over their approved capacity of the program on any given day. This proposal was rejected by DOH in favor of allowing programs to exceed their capacity on any given day by 10 percent as long as the average annual capacity does not exceed the approved capacity of the program. This is the capacity limit in current regulation.

These regulations will not be in effect until after the comment period (ends July 11) and until the Public Health and Health Planning Council (PHHPC) approves them. The earliest date that the PHHPC will be in a position to approve the proposed regulations is Oct. 2, 2014.

The ADHCC will be hosting a free member-only conference call on the proposed regulations on Wed., June 25 at 10 a.m. LeadingAge NY members who sponsor ADHC programs are, of course, welcome to participate on the call. The conference call will last 90 minutes and will allow time for questions and answers. The conference call will be free, but you must register for it. To register for the free member conference call, click here.   We will provide members who register for the conference call with the dial-in information two days before the conference call. Handouts will be provided the afternoon before the conference call.

Contact: Christine Fitzpatrick, cfitzpatrick@leadingageny.org, 518-867-8383 ext. 130 or Anne Hill, ahill@leadingageny.org, ext. 141 with any questions.