GIS 14 MA/026: State Disaster Emergency in Western New York Counties - Fee-for-Service Medicaid Processes During the Disaster Emergency

To: All Local District Commissioners, Medicaid Directors,

From: Jason Helgerson, Medicaid Director

Subject: State Disaster Emergency in Western New York Counties - Fee-for-Service Medicaid Processes During the Disaster Emergency

Effective Date: Immediately

The purpose of this GIS is to advise local departments of social services (LDSS) in the Counties of Cattaraugus, Chautauqua, Erie, Franklin, Genesee, Herkimer, Jefferson, Lewis, Oswego, Wyoming and contiguous counties, of the implementation of specific authorization and eligibility verification processes in effect during this State disaster emergency.

Due to the potential impact of this disaster, the Fee-for-Service Medicaid personal care services program and the consumer directed personal assistance program is implementing the following processes until the State disaster emergency has ended.

  • 1. During the State disaster emergency, Fee-for-Service Medicaid will relax Prior Authorization requirements for the provision of urgent services.
  • 2. Providers will not be required to request authorization to treat enrolled participants for the provision of urgent services and will be reimbursed accordingly.

Please see the attached Executive Order No. 139 issued by Governor Andrew M. Cuomo regarding temporary suspension and modification of health statutes and regulations during the state disaster emergency. On November 18, 2014, by Executive Order No. 137, Governor Andrew M. Cuomo declared a disaster in the Counties of Cattaraugus, Chautauqua, Erie, Franklin, Genesee, Herkimer, Jefferson, Lewis, Oswego, Wyoming, and contiguous counties. Please act during this state of emergency in the best interest of your members and utilize special considerations as warranted.

Additional questions related to the provision of personal care and consumer directed personal assistance services during this State disaster emergency may be directed to Karis Browder at (518)474-5888.