NYS Budget Aims to Keep Network of CDPAP Fiscal Intermediaries Intact

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In December 2019, the New York State Department of Health (DOH) issued a Request for Offers (RFO) from fiscal intermediaries (FIs) to enter into contracts with the DOH to provide FI services in the Consumer Directed Personal Assistance Program (CDPAP) for persons enrolled in Medicaid fee-for-service and Medicaid managed care programs. The CDPAP provides services to chronically ill or physically disabled individuals who have a medical need for assistance with activities of daily living (ADLs) or skilled nursing services. FIs provide administrative services to participating consumers and personal assistants (PAs), including processing service authorizations and PAs’ wages and benefits.

In February 2021, of the 373 FIs that were determined by the DOH to meet the minimum criteria of the RFO, only 68 FIs were awarded contracts following a scoring and review process conducted by the DOH. In response to complaints by FIs that were not chosen for contracts last year, the State’s 2022-23 fiscal year health and mental hygiene budget (signed into law on April 9, 2022) instructs[1] the DOH to accept offers to enter into contracts with all of the FIs that meet the minimum criteria of the RFO but were not initially awarded contracts. Those FIs may reapply if they can attest that:

  1. The FI was providing FI services for at least 200 consumers in New York City at any time between January 1, 2020 and March 31, 2020; or
  2. The FI was providing FI services for at least 50 consumers in another area of the state at any time during that period.

Once the DOH publishes an attestation form (or other process) on its website, FIs that meet the above criteria will have 60 days to submit the attestation. Contracts awarded will be limited to the service areas indicated on the FI’s RFO submission.

[1] See Part PP (S 8007-C /A 9007-C).

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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