A new level of bureaucracy is being imposed on licensed home care services agencies (LHCSAs). Under recent budget legislation, any LHCSA serving Medicaid recipients, whether directly or through a Medicaid managed care organization, will require a contract with the Department of Health authorizing the agency to enroll and provide medical assistance and submit claims for services.
This new requirement is in addition to licensure and Medicaid enrollment requirements and applies to services under the Medicaid state plan or federal waivers. This requirement is subject to the state obtaining federal approval.
The NYS Department of Health (DOH) is required to develop and publish LHCSA services to be provided and criteria for selection of LHCSA contractors by geographic region on its website for at least 30 days. There will be no administrative review of DOH contracting decisions.
Additionally, the DOH is directed to secure the services of an independent assessor or assessors to conduct assessments and reassessments of an individual’s needs for personal care services, including consumer directed personal care services, no later than October 2022. This will replace local departments of social services and managed care organization assessments. A solicitation will be posted on the DOH website.
Barclay Damon LLP will continue to monitor developments to assist our clients in responding to contracting solicitations and addressing contracting criteria.
If you have any questions regarding the content of this alert, please contact Gene Lakes, partner, at elaks@barclaydamon.com or another member of the firm’s Health Care & Human Services Practice Area.