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LTHHCP Billing Update

On Jan. 23rd, the Department of Health (DOH) sent a notice clarifying how Long Term Home Health Care Program (LTHHCP) providers can operate even though the LTHHCP waiver has been discontinued. According to the notice, "LTHHCPs with valid operating certificates may directly admit and serve patients under their LTHHCP/CHHA-authorization."

Medicaid waivers

LTHHCP providers may contract with Medicaid waiver programs to provide home health services to Medicaid waiver program enrollees or fee-for-service Medicaid recipients.

Home health agency capacity

LTHHCPs may:

Directly admit and serve Medicaid and dual Medicare-Medicaid patients consistent with state and federal CHHA guidelines.

Directly admit and serve Medicare, private pay, and private insurance patients under applicable Medicare, Article 36, and/or State Insurance Law standards.

“Effective October 1, 2016, LTHHCP providers, delivering home health services, are granted access to bill Medicaid using the appropriate CHHA Episodic Pricing System rate codes. It should be noted that LTHHCP providers which take advantage of this opportunity will also be required to file the appropriate CHHA costs reports each year.”

If you have any questions, please send an email to bltcr-ch@health.ny.gov.

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