DOH Issues Policy to Medicaid Health Plans on CDPAS Agreement

(July 8, 2025) The Department of Health (DOH) circulated and posted a Medicaid Managed Care (MMC) policy meant to supplement a recent presentation given to MMC plans. The policy, which applies to Managed Long Term Care (MLTC) plans as well, reminds plans of their responsibilities and of the actions that must be taken under the Amended Preliminary Injunction ordered by the Court on June 27, 2025 in Engesser, et al v McDonald in the US District Court in the Eastern District of New York.

The terms of the agreement require that letters be sent to: (1) consumers authorized for but not in receipt of CDPAP services; (2) consumers who are utilizing a Fiscal Intermediary (FI) other than PPL as authorized under the original preliminary injunction; and (3) consumers who are fully registered with PPL. The agreement also requires that additional outreach attempts be made to consumers enrolled in MLTC, specifically those in Partially Capitated MLTC and Medicaid Advantage Plus (MAP) plans. Consumers who are not in receipt of CDPAP or not in the process of registering with PPL by August 1, 2025, may be issued a Discontinuation of Services Notice and/or an MLTC Disenrollment Notice with fair hearing rights.

The Policy document is posted on the DOH CDPAS Transition web page here.

Contact:  Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841