Fiscal Intermediary FFS Rate Cuts Suspended

The Department of Health (DOH) posted a Dear Administrator Letter (DAL) last week suspending recent Fee-for-Service (FFS) rate changes to Fiscal Intermediary (FI) services provided under the Consumer Directed Personal Assistance Program (CDPAP). The letter suspends previous DALs dated Aug. 30, 2019 and Sept. 17, 2019 and directs FIs to be reimbursed at previous FFS rates. Recently, the State Supreme Court declared DOH's Managed Care Policy containing the Per Member Per Month (PMPM) tiered reimbursement structure for FIs null and void. Please see LeadingAge NY's recent Intelligence article and the decision for the case here. The court ruled that DOH must follow the State Administrative Procedure Act (SAPA) regulatory process before such an action may be taken.

LeadingAge NY will keep members apprised of this matter.

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