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Transition Policy Issued for MLTC Plans, CDPAP Consumers, and Fiscal Intermediaries

The Department of Health (DOH) has issued Managed Long Term Care (MLTC) Policy 20.01: Transition Policies for Fiscal Intermediaries (FIs) and Consumers under the Consumer Directed Personal Assistance Program (CDPAP). The policy and related documents are posted on the Department’s MLTC Policy page.

This transition policy facilitates the transfer of services from entities currently providing FI services that decide or are required to cease operations as a result of the Request for Offers (RFO) which established a new authorization process for FIs serving the CDPAP program. Entities denied or authorized FI status have not been released as of yet. This policy is effective immediately and provides guidance primarily to Current FIs and Managed Care Plans for transitions both before and after when the Department will announce the entities selected to provide FI services pursuant to the RFO on the “Contract Notification Date.”

To ensure continuity of care and an orderly and efficient transition for CDPAP consumers that may need to select and transition to a Receiving FI, the Department will permit all Current FIs that did not submit an offer and were not included as a Collaborating Partner in any offer under the RFO to continue to operate until the Contract Notification Date.

To be eligible to operate during this time period, Current FIs that neither submitted an offer under the RFO nor were included as a Collaborating Partner in any offer must notify the Department of their intent to continue operations through this period on or before March 20, 2020 by submitting an election form, which can be found on the Department’s MLTC Policy page, to ConsumerDirected@health.ny.gov.

For ease of use, this policy is broken down into five scenarios. In each scenario, the process, time frames, and responsibilities for Current FIs and other entities regarding how to cease operations may be different. Certain decisions made by Current FIs regarding closure can affect which scenario applies. The five scenarios are as follows:

  • Scenario 1 – Current FIs that do not submit an offer as Lead FI under the RFO, are not a Collaborating Partner in any offer made in response to the RFO, and elect to cease operating before the Contract Notification Date;
  • Scenario 2 – Current FIs that do not submit an offer as Lead FI under the RFO, are not a Collaborating Partner in any offer made in response to the RFO, and elect to continue operating until the Contract Notification Date;
  • Scenario 3 – Current FIs that submit an offer as Lead FI under the RFO in any offer made in response to the RFO, but are not selected;
  • Scenario 4 – Collaborating Partners; and
  • Scenario 5 – Current FIs that elect to cease operations immediately.

Various requirements are set forth in the policy and depend upon the circumstances and/or decisions of each FI. Requirements include:

  • Model templates for notification;
  • Consumer consent forms;
  • Time frames for all actions;
  • Prohibited activities of FIs;
  • Managed Care plan and Local Department of Social Services (LDSS) notification; and
  • Consumer rights.

Please consult the appropriate pages of the policy document for the specific transition requirements that address your situation. Questions regarding these FI transition provisions should be directed to DOH at ConsumerDirected@health.ny.gov.

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