Consumer Directed Personal Assistance Reimbursement Changes Expected Aug. 1st
(July 30, 2024) Beginning Aug. 1st, the administrative component of fiscal intermediary (FI) rates in the Consumer Directed Personal Assistance Program (CDPAP) will be reimbursed on a "managed fee for service" basis. As previously reported here, the administrative component will be carved out of managed care plan capitation and paid separately through a complex billing process involving plans, the Department of Health (DOH), and FIs. Plan premiums will be reduced on a regional basis, retroactive to April 1st, to reflect the carve-out.
These changes and related FI contract amendments may affect managed care plan and FI network relationships and ultimately the consumers in CDPAP and their personal assistants. Several FIs have filed suit against the State, challenging the new payment arrangement, arguing that it violates existing regulations and the State Administrative Procedure Act.
LeadingAge NY will keep members apprised of any developments in the State's policy or its implementation. More information is available in the May 2024 Medicaid Update and on the LeadingAge NY website here.
Contacts: Karen Lipson, klipson@leadingageny.org, and Darius Kirstein, dkirstein@leadingageny.org