Budgeted Rates

  • Letter is also available in Portable Document Format (PDF)

October 1, 2024

Dear Administrator:

RE: 2024 Budgeted Projected Statements for Licensed Home Care Service Agencies (LHCSA - Personal Care) and Consumer Directed Personal Care Assistance Program/ Fiscal Intermediary (CDPAP-FI)

The Department of Health has developed a new process for LHCSA and CDPAP-FI providers to request fee-for-service (FFS) rates. These requests could be related to:

  • The creation of a new agency;
  • An existing agency beginning to provide services in a new county; or
  • An existing agency expanding their services to provide new services in a county for which they are already authorized.

These requests are NOT for updating existing rates, nor for any Managed Care/Managed Long Term Care rates.

Agencies seeking budgeted FFS rates will request access to the Budgeted Rate process, and once approved by the Department, submit the Budgeted Projections Statement (General Information and Rate Setting Schedules) in the web-based Tool. Once submitted, this information will be used by the Department to calculate a budgeted rate. Detailed written instructions are included (Attachment A) and posted on the Department’s website: Home Care Cost Report (ny.gov)

Please note, all other requirements and processes for establishing budgeted rates have remained the same. Per NYCRR Title18, Section 505.14, Personal Care providers are required to contract with the County’s Department of Social Services (LDSS) for the provision of Personal Care services. The web-based Tool will not be opened for providers until the Department receives the County’s Notification of District Interest Form (example in Attachment B). Additionally, once operational and actual data is available, providers are required to submit the Annual Home Care Cost Report, from which cost-based rates will be set.

If you have any questions regarding the information contained in this correspondence contact the Bureau of Nursing Home and Long Term Care Rate Setting email inboxes as follows: for LHCSAs and FIs PersonalCare-Rates@health.ny.gov.

Sincerely,

Laura Rosenthal, Director
Bureau of Nursing Home and Long Term Care Rate Setting
Division of Finance and Rate Setting
Office of Health Insurance Programs

Enclosures:
Attachment A - Home Care Budgeted Projections Statement Instructions (separate PDF attached)
Attachment B - Notification of District Interest Form (separate PDF attached)