Updated DAL Issued Regarding Telehealth for Home Care and Hospice Providers

(Sept. 17, 2024) The Department of Health (DOH) recently issued an updated Dear Administrator Letter (DAL) on telehealth which focuses solely on home care and hospice. This is a clarification of the October 2023 DAL on telehealth which addressed home and community-based services providers generally, including adult day health care (ADHC) and adult care facilities (ACFs).

This guidance clarifies that providers may use telehealth under federal and state license requirements, provided that use is consistent with Medicare and Medicaid waivers and guidance, commercial insurance requirements, and patient choice. In addition, it is the responsibility of the provider to be knowledgeable of and compliant with Medicare and Medicaid regulatory flexibility and timelines.

Remote technology use in home health care and hospice will not be allowed for the following: 

• For in-person initial medical, clinical, mental health, or dental assessments.
• To perform the Functional Supplement component of the Uniform Assessment System for NY (UAS-NY). 
• At any time when the patient is not able to access a secure location.
• As a substitute for in-person delivery of any personal care services by a provider licensed under Article 36 of the Public Health Law.

Additional guidance can be found in the NYS Medicaid Update February 2023 Special Edition, which provides comprehensive guidance regarding use of telehealth following the expiration of the COVID-19 public health emergency.

It is the Department’s expectation that providers will develop or have in place screening procedures for appropriate patient use and eligibility; training of personnel, patients, and/or family members to ensure ability to use the technology; documentation of informed choice and consent by patients; and equipment policies and procedures, inclusive of use, storage, and cleaning. These protocols will be incorporated into the DOH survey process. The State recognizes that technology has a valid place in health care, and this updated programmatic guidance is intended to clarify this policy. Questions may be sent to homecare@health.ny.gov.

LeadingAge NY and the Adult Day Health Care Council will continue to advocate for broader telehealth flexibilities in ACFs and ADHC programs.

Please let us know if you have concerns with or questions regarding the new guidance.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871