CDPAP Fiscal Intermediaries Must File an Application for Authorization With DOH or Cease Operations

by FordHarrison
Contact

FordHarrison

Executive Summary. On November 1, 2017, the NYS DOH issued its "Application for Fiscal Intermediary Authorization" and implementation guidelines. Significantly, DOH imposed a very short timeframe, stating: "As of November 1, 2017, all existing FIs will have thirty (30) days to submit their FI Authorization application to the Department." If no filing is made, the FI must cease operating under CDPAP. Those who wish to begin operating an FI may also want to file by this date. A copy of the application can be obtained at https://www.health.ny.gov/health_care/medicaid/redesign/mrt_10003.htm

The Application. The application is designed to obtain complete information about the entity operating under CDPAP -- its corporate documents, ownership, leadership, organizational structure, and any related organization that will have the ability to direct or cause direction of actions, management or policies of the FI. The application filing is made under penalty of perjury. DOH may request additional information.

Schedule 1 to the application requires detailed personal information from each principal stockholder or LLC member and managing member, officers and Board members of the FI and any related organizations and relatives of any person submitting, which information includes, among other things, 5 year employment histories, any criminal, civil or administrative actions against them or state enforcement actions against facilities they or their relatives were affiliated with, and personal associations for the past 10 years with any licensed or certified health care entities in or outside New York State, including documentation to show that any associated out-of-state entity was in substantial compliance with that state's applicable codes, rules and regulations.

In addition the application requires submission of numerous documents, among which are (i) a certified copy of a Board resolution authorizing submission of the application and confirming the FI's corporate authority to operate under CDPAP; (ii) the FI's policies and procedures, including any contracts or other documents used in communications with Consumers; (iii) all marketing and outreach materials; and (iv) plans to solicit and consider input from Consumers and other interested parties about the FI's services.

Observations. The application is clearly intended (i) to obtain detailed information about the bona fides of all individuals who own, serve in decision-making roles or manage an FI, or seek to do so, and any entities, parent or otherwise, that can influence any decisions, policies or practices of the FI; (ii) to allow DOH to review an FI's marketing and outreach materials and any contracts or other documents used in communications with Consumers to determine whether these materials are consistent with NYS guidance on CDPAP; and (iii) to reiterate what Fiscal intermediaries are prohibited from engaging in. Indeed, the application contains the specific admonition: "activities in which an FI should not be engaged, such as recruiting and hiring personal assistants, [are] as set forth in the Consumer-Directed regulations under Title 18 NYCRR §505.28. It has never been, nor will it ever be, appropriate for an FI to participate in such activities."

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.

© FordHarrison | Attorney Advertising

Written by:

FordHarrison
Contact
more
less

FordHarrison on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
Privacy Policy (Updated: October 8, 2015):
hide

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.

Security

JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at info@jdsupra.com. In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at: info@jdsupra.com.

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.