The Department of Health (DOH) has released a Request for Offers (RFO) which is an open and competitive purchasing process, meaning they are creating a blank slate and seeking offers from qualified organizations to provide CDPAP Fiscal Intermediary services.
Currently, there are about 600-700 Fiscal Intermediaries in New York State providing services to consumers. This RFO is DOH’s way of deciding which of the 600-700 FIs will be permitted to continue providing CDPAP as a service. It is expected that DOH will consolidate the amount of Fiscal Intermediaries, and will not award contracts to many that apply. Additionally, many FIs do not have the resources nor are capable of completing the RFO, which would render them ineligible to continue providing the program.
In addition to the RFO, the Department of Health has released proposed regulations defining an administrative reimbursement change to CDPAP Fiscal Intermediaries. For many FIs, this reimbursement change to a per member/per month (PMPM) structure will mean a 60-85% cut, and will discourage many from continuing services.
*An important note: This reimbursement change is only for the Fiscal Intermediary administrative portion, and does not affect the personal assistant’s pay.*
Many Consumers may need to choose a new Fiscal Intermediary if their current one is not awarded a contract or does not wish to continue with the new reimbursement structure. It is important for Consumers and Personal Assistants in CDPAP to know that the RFO and reimbursement changes do not mean CDPAP is ending. The program will remain, and there will still be Fiscal Intermediaries providing services. Pay close attention to what your current Fiscal Intermediary directs you to do. If they are planning to cease CDPAP operations, they are required by law to give 45 day notice to the Consumer and Personal Assistants. Do not let your current Fiscal Intermediary force you into their personal care or home health care program. These are not consumer directed programs, and do not have the same benefits as CDPAP. If your Fiscal Intermediary tries to push you and your Personal Assistant into a personal care or home health care program division of their agency, then please know that it is against the law. The law clearly states that Fiscal Intermediaries that cease business shall not take any action that would prevent a Consumer from switching to another CDPAP Fiscal Intermediary, nor require the Consumer to switch to a personal care or home health care program.
Premier Home Health Care will be a stable option for those Consumers and Personal Assistants who need to switch out of their current Fiscal Intermediary. Premier Home Health Care has experience in the per member/per month reimbursement structure and is planning to continue CDPAP operations. If you have any questions about these changes please feel free to contact us today! 866 720 0124