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LeadingAge NY Comments on Revised Proposed Rule on Personal Care/CDPAS Assessment and Eligibility

LeadingAge NY submitted comments on the Department of Health's (DOH) re-published proposed regulations governing the independent assessment process for personal care services and Consumer Directed Personal Assistance Services (CDPAS). The comments supported the Department's decisions to exempt Programs of All-Inclusive Care for the Elderly (PACE) from the new independent assessment process and to allow physician assistants and nurse practitioners, in addition to physicians, to sign the medical orders for personal care and CDPAS. The comments included a number of recommendations, including the following:

  • Recognize the need for ongoing plan-based assessments, and maintain payment for those assessments in Managed Long Term Care (MLTC) rates.
  • Delay the effective date of the regulations until at least July 1st, and phase in implementation, beginning with assessments of new applicants only. Implement independent, change-in-condition assessments at a later date.
  • Recognize the federally mandated PACE eligibility standard, and clearly state that the minimum needs criteria do not apply to prospective and enrolled PACE members. Although the proposed regulations exempt PACE from the independent assessment, they do not exempt the program from the new State eligibility requirements.
  • Ensure timely completion of recertification and change-in-condition assessments and Independent Review Panel (IRP) recommendations, including, for expedited requests, the availability of same-day change-in-condition assessments and IRP recommendations.
  • Eliminate monetary penalties as a possible consequence of overuse of the correction and clinical disagreement process.

More information about the regulations is available here and here. LeadingAge NY's comments are here.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838