Preliminary Injunction Extends Deadline for CDPAP Transition for Certain Consumers/PAs
(April 15, 2025) A preliminary injunction, issued by the U.S. District Court for the Eastern District of NY on April 10, 2025, has extended the deadline for Consumer Directed Personal Assistance Program (CDPAP) consumers to register with the single fiscal intermediary (FI), PPL, until May 15, 2025, and for their personal assistants (PAs), until June 6, 2025. The preliminary injunction is intended preserve access to services and payment for CDPAP consumers and PAs during their transition to PPL. In order to implement the preliminary injunction, the Department of Health (DOH) has issued guidance on employment and payment of PAs and the role of managed care organizations (MCOs) during the period of the injunction.
The extension provided by the preliminary injunction applies only to consumers and PAs who were receiving CDPAP services prior to April 1, 2025 and have not yet fully registered and/or fully onboarded with PPL. Consumers and their PAs who have completed the registration and onboarding process with PPL are not affected by the preliminary injunction. These PAs will be employed and paid by PPL. Nor does the preliminary injunction affect consumers newly beginning CDPAP services or a new authorization for CDPAP services on or after April 1, 2025. They must register with PPL and cannot use another FI to provide payments to a PA. These “new” consumers include individuals with CDPAP transitioning from one MCO to another or from a Local Department of Social Services (LDSS) to an MCO, as well as those new to CDPAP.
The DOH guidance addresses three categories of transitioning consumers/PAs:
Category A: Fully Registered Consumer, Fully Onboarded PA: This category includes consumers who are fully registered with PPL and their PAs who are fully onboarded with PPL. PAs in this category may submit time worked via PPL’s app Time4Care, the telephony system, and via paper timesheets for those who qualify.
Category B: Fully Registered Consumer, Not Fully Onboarded PA: PAs in this category may be paid by their prior FI (Prior FI), pending the completion of their onboarding, but only if the conditions below are met. The consumer or their designated representative (DR) must initiate the request to their MCO for the PA to be paid by the Prior FI. MCOs must accept a request made via reasonable means, such as telephone or email. The following requirements must be met in order for the Prior FI to provide payment to a PA:
- The consumer’s MCO is capable of updating the authorization from PPL to the Prior FI in sufficient time that the worker can be paid by the Prior FI within seven calendar days of the consumer making the request.
- The Prior FI exists, is operational, and does not have a legal impediment to pay PAs. The Prior FI must have made timely payments to the PA through March 31, 2025 and agree to employ and make timely payments to the PA, until that PA is fully onboarded with PPL.
- The Prior FI agrees to a payment arrangement with the MCO that does not significantly differ from the arrangement that existed prior to April 1, 2025.
- The Prior FI agrees not to make misrepresentations to any consumer or PA regarding the CDPAP transition.
If the MCO confirms that the above requirements are met, and the PA can return to the Prior FI for payment, the MCO will make the system adjustments to allow claims payment to the Prior FI. The MCO is required to provide their contract/single case agreement with the Prior FI to DOH and document that the FI is able to meet the requirements laid out above. MCOs should communicate changes to their PPL Account Manager in addition to updating authorizations. These consumers must complete their registration with PPL no later than May 15th, and their PA must be fully onboarded by June 6th.
Category C: Not Fully Registered Consumers: Consumers in this category are those who began, but have not completed, the registration process with PPL, or who have not started the process. MCOs are required to contact all consumers in this category by their preferred communication method, before April 15, 2025, to determine their intentions regarding registration. For those consumers who request that their PA(s) be paid by the Prior FI while the registration and PA onboarding with PPL is finalized, the MCO should determine whether the above requirements can be met and support the consumer accordingly. At the end of the day on April 15, 2025, the MCO must provide the Department with documentation of outreach to all consumers in this category.
All consumers in this category must complete the registration process with PPL before the registration deadline of May 15, 2025. MCOs are responsible for assisting consumers and their workers with PPL registration and onboarding and should exhaust their ability to do so before escalating the member to PPL.
More information and the complete text of the guidance are available on the DOH website here.
Contact: Karen Lipson, klipson@leadingageny.org