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DOH Issues Guidance on PC/CDPAS Regulation Implementation

The Department of Health (DOH) has circulated direction on the implementation timeline for recent changes to Personal Care (PC) and Consumer Directed Personal Assistance Services (CDPAS) regulations (18 NYCRR sections 505.14 and 505.28). The communication lists the regulatory additions and amendments that will become effective on Nov. 8th as well as the provisions that are pended for implementation at later, yet to be announced, date or dates. DOH indicates that it will issue additional direction to announce the later effective date(s) and provide the implementation timeline for future changes. It is anticipated that these later changes will not be effective prior to Jan. 1, 2022, and the Department intends to provide at least 60 days prior written notice of these changes taking effect. The document is available here. Background information and links to the regulatory text are here.

Along with a number of terminology/definition clarifications, several of the provisions that are effective Nov. 8th include the documentation for medical necessity determinations, organization of appropriate level of services for members, authorization for DOH to continue the current assessment process if sufficient capacity is unavailable to implement Independent Assessor (IA) provisions (when they become effective), and prohibition of members from working with more than one fiscal intermediary (FI) at a time. Please note that the change from 6- to 12-month assessments will be effective on Nov. 8th and will be applied in the Uniform Assessment System (UAS) for assessments completed on and after Nov. 8th.

The IA process, change in enrollment eligibility criteria, and independent medical review panel provisions are all pended until further notice.

The letter notes that the Department is developing a pre-recorded webinar and slides to provide further detail regarding the provisions effective Nov. 8th. The webinar will be posted to the Medicaid Redesign Team (MRT) II website here under the “Long Term Care” section on or about Nov. 12th. DOH asks that questions be directed to independent.assessor@health.ny.gov.