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Consolidation of the Care at Home III, IV, and VI Waivers

Last week, eMedNY posted new billing guidance as a result of the Centers for Medicare and Medicaid Services (CMS) approving the consolidation of the Care at Home (CAH) III, IV, and VI waivers into the “OPWDD Care at Home Waiver.” This consolidation was effective January 2017. This waiver will continue to serve medically fragile children under the age of 18 who have a developmental disability and live at home with their parent(s) or legal guardian(s). Per the guidance, "the purpose of the consolidation is to streamline and strengthen New York State’s administrative oversight and reporting mechanisms for these waiver programs."

The new billing guidance can be found here. This includes three rate codes for case management services that must be used for services that begin in April, regardless of which waiver the child was enrolled in prior to April. The guidance also includes details on rate codes that will be denied after April and the one Restriction/Exemption Code that will be used for all children in the OPWDD CAH waiver.

Any questions can be directed to Lynda Baum-Jakubiak, Statewide CAH Coordinator at 518-486-6466 or via email at careathome@opwdd.ny.gov.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871