Revised Private Duty Nursing Manual Available on eMedNY
A revised Private Duty Nursing (PDN) Manual has been published with an effective date of Nov. 25, 2019. The manual may be found here under the link entitled “Policy Guidelines.” The manual presents PDN Policy and Procedure in a revised, organized format that should provide clearer instructions to providers, streamline processes for prior approval (PA) submission, and make it easier to find information.
Highlights of revisions to the current PDN PA process include the following:
- One PA per member – no longer need separate PAs for agency and independent providers (Section 6.6)
- Documentation required for PA submissions – clarified and streamlined for certain PA submissions (Section 6)
- Assessments – clarified and alternative documentation outlined that would meet the requirements (Section 6.10)
- Clarification of PDN in School setting (Section 11.2)
- Replacement PAs and Change Requests – clarify the processes and outline when to use (Section 9)
- Third Party Insurance Information – provides information to providers for required documentation (Section 6.16)
The Bureau of Medical Review will be conducting a webinar on Nov. 4, 2019 at 10 a.m. for PDN servicing providers, physicians, or any other enrolled Medicaid professional that provides services or assists in submission of PAs to review the highlights of the revised manual. Time will be available at the end of the presentation to answer questions from participants.
To enroll in the webinar, click here or visit the Provider Training Page on the eMedNY website.
Please contact the Bureau of Medical Review at 1-800-342-3005 or OHIPMEDPA@health.ny.gov with questions about the revised manual.
For assistance in registering for the webinar, please contact CSRA at 1-800-343-9000.
Contact: Meg Carr Everett, meverett@leadingageny.org, 518-867-8871