Update: Contracting for Home Health Services with Managed Care Plans

The Department of Health (DOH) posted another Dear Administrator Letter (DAL) along with several attachments to the Health Commerce System (HCS) on contracting for home health services with managed care organizations. DOH stated after the first DAL that a second DAL would be posted along with a Frequently Asked Questions (FAQ) document. In this posting, DOH included the scope of practice for both home health aides and personal care aides.

LeadingAge New York and other associations have contacted DOH with their questions and concerns in response to the first DAL, requesting clarification on contracting issues such as: What home care entitites can contract with managed care organizations and for what home care services? In the FAQs, some questions have been answered but several remain, such as: Is PACE excluded from this DAL? What home care services are outside of the Conditions of Participation? What is the timeframe to execute these changes with contracts after clarification is received from DOH?

LeadingAge New York has brought these questions to the Home and Community-Based Care Work Group during the last year, and submitted legislative language with the Home Care Association (HCA) of New York State that provides a vehicle to resolve some of these unanswered questions.

We will continue to request clarification on these issues and will keep you informed.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871