powered by LeadingAge New York

DOH Posts Personal Care and CDPAS Medicaid Rates

The Department of Health (DOH) posted all-inclusive Personal Care and Consumer Directed Personal Assistance Services (CDPAS) Medicaid reimbursement rates effective Jan. 1, 2019. Payment for the rates will be made in cycle 2188, with a check release date of Aug. 14, 2019. The rates are based on the lower of the 2017 allowable costs (held to ceiling) projected to the 2019 rate period or established charges as reported by agencies. For Licensed Home Care Services Agencies (LHCSAs) that did not submit a 2017 certified Cost Report, the Department is not able to determine an initial 2019 rate until the certification(s) are submitted.

A Dear Administrator Letter (DAL) and Attachments flesh out the rate components, which include Trend Factor, Administrative and General Caps, Aide and Training Ceiling, Capital Costs, Profit Surplus Percentage, Worker Recruitment and Retention, and a new Miscellaneous Adjustment Line to meet mandates not part of the original methodology. Attachment B provides an outline of the rate appeal process. Providers have 90 days from July 22nd to submit appeal(s) to the posted rates.

The rates are accessible via the Health Commerce System (HCS) under the Healthcare Financial Data Gateway. If you have any questions regarding the above information, please send an email to PersonalCare-Rates@health.ny.gov, and Robert Yankowski will respond to your inquiries.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871