MLTC Policy 15.05(a): Clarification on Requirements for Consumer Directed Personal Assistance Service (CDPAS) Fiscal Intermediaries.

Office of Health Insurance Programs
Division of Long Term Care
MLTC Policy 15.05(a): Clarification on Requirements for Consumer Directed Personal Assistance Service (CDPAS) Fiscal Intermediaries.
Date of Issuance: November 4, 2015

The purpose of this policy document is to provide clarification on specific requirements pertaining to MLTC Policy 15.05: Clarification on Requirements for Consumer Directed Personal Assistance Service (CDPAS) Fiscal Intermediaries. The following Questions and Answers respond to inquiries received by the Department regarding MLTC Policy 15.05.

General Questions

Q1. If an organization already has a Medicaid MMIS number, is another one required to provide CDPAS in accordance with MLTC Policy 15.05?

A1. No. If there is already an active Medicaid MMIS number on file, applying for an additional number is not required. All organizations that do not have an active Medicaid MMIS number must apply for one in accordance with the guidance provided in MLTC Policy 15.05.

Q2. Some of the MLTCPs that my CDPAS Fiscal Intermediary (FI) have signed Administrative Agreements with are now asking that we provide information above and beyond our MMIS number. For example, plans are asking for our criminal background check protocols. Are FIs exempt from this requirement?

A2. The CDPAS is not designated by Public Health Law §2899-a and 18 NYCRR §505.28 to conduct criminal history background checks. Therefore, the FI is excluded from the activity and should not be acting outside the scope of the Department´s programmatic requirements.

Q3. My agency applied for a Medicaid MMIS number so that we can contract with MLTCPs. Our application was processed and a number was approved, but we never received any documentation that we could provide the plan as evidence of our number. Apparently, only applicants seeking fee-for-service rates receive a formal letter from the Medicaid program. What can we give the plans if Medicaid is not going to issue a letter?

A3. Once an organization has received their MMIS number from the Department of Health, the organization can send a letter to the plan with the designated number indicating that their number was approved and is now active. Plans may also contact Computer Science Corporation at the eMedNY call center, 1-800-343-9000, to confirm enrollment.