New York Independent Assessor Program Frequently Asked Questions

  • FAQs also available in Portable Document Format (PDF)

GENERAL

Q. Does the New York Independent Assessor Program conduct assessments for children?

A. No, at this time, all pediatric assessments (for children aged 0-3 and aged 4-17) are excluded from the New York Independent Assessor Program process. The Local Department of Social Services (LDSS) or the Medicaid Managed Care (MMC) plans, including MMC plans, HIV Special Needs Plans (HIV SNPs), and Health and Recovery Plans (HARPs) are required to conduct the Pediatric Community Health Assessments and obtain a physician order form (DOH- 4359 or HCSP-M11Q) prior to assessment.

Q. Does the Physician Order need to be completed for every assessment?

A. Yes, the Physician Order (DOH-4359) is required prior to each reassessment and all pediatric initial assessments. The practitioner order will be completed for all initial assessments completed by NYIAP.

NEW YORK INDEPENDENT ASSESSOR PROGRAM APPOINTMENT SCHEDULING

Q. How can an individual request an initial assessment?

A. An individual or their authorized representative can call the New York Independent Assessor Program’s toll-free helpline to request an initial assessment. The number is 855-222-8350 (TTY: 1-888-329-1541). . Medicaid Managed Care Organizations (MMCO’s) and Local Departments of Social Services (LDSS) should refer individuals to this number to schedule initial assessments with New York Independent Assessor Program.

Q. Can an authorized representative call on behalf of an individual to schedule an assessment?

A. Yes, an authorized representative can call on behalf of an individual. The authorized representative needs to be on file with the New York Independent Assessor Program. For more information, on designating an authorized representative, click here.

Q. Can an individual choose between an in-person appointment or a telehealth appointment to have a Community Health Assessment and clinical appointment completed by the New York Independent Assessor Program?

A. Yes, the New York Independent Assessor Program offers two ways to have your appointment conducted. An individual can choose between in-person or video-visit (telehealth) for their Community Health Assessment and/or clinical appointment.

Q. How long should I expect my Community Health Assessment and clinical appointments to take?

A. Most Community Health Assessment appointments take between 2-3 hours to complete. The clinical appointment takes up to 1 hour.

Q. What happens if I have an urgent need for personal care services and/or consumer directed personal assistance services?

A. If you are not currently receiving personal care services and/or consumer directed personal assistance services, and you have a significant change in your medical condition that causes an urgent need for services, you should contact your Local Department of Social Services or your Medicaid Managed Care plan to request assistance in scheduling an assessment right away. If you are already in a Medicaid Managed Care plan, you should contact your plan. If you are not enrolled in a health plan, contact your Local Department of Social Services. They will call NYIAP with you on the line to schedule an assessment.

COMMUNITY HEALTH ASSESSMENT AND PRACTITIONER ORDER

h5>Q. If an individual is receiving waiver services can they also receive personal care services and/or consumer directed personal assistance services?

A. Yes, an individual can receive personal care services and/or consumer directed personal assistance services with waiver services as long as there is no duplication of services provided.

Q. Are FFS Medicaid individuals required to enroll in a Managed Long Term Care (MLTC) plan if the NYIAP Assessment determines an individual eligible for MLTC?

A. No, individuals have the option to receive services through the Local Department of Social Services or to select a MLTC plan. If the individual begins services through the LDSS and is in a population mandatory for MLTC enrollment, the individual will be notified by New York Medicaid Choice (NYMC) when they become mandatory for MLTC enrollment.

Q. Should Plans and LDSS perform an additional initial assessment after NYIAP has completed their initial assessment?

A. No, the purpose of the New York Independent Assessor Program is to perform initial assessments for individuals seeking PCS/CDPAS and MLTC enrollment. When the Plan or LDSS finds discrepancies within the NYIAP assessment, they must follow the Variance process outlined in the OHIP ADM 22-01, MLTC Policy 22-01 or MMC Guidance April 28, 2022.