July 15, 2020
Today’s NY State Register includes a Notice from the NYS Department of Health stating its’ intent to make changes to the Children’s HCBS program, including application of the Across the Board payment reductions that were included in the April 1, 2020 enacted state budget. Specifically, a 1.5% rate cut will go into effect on September 1, 2020. An additional 0.5% rate cut will go into effect on April 1, 2021.
In addition, the New York State Department of Health (DOH) is submitting requests to CMS to amend the 1915(c) Children’s Waiver Home and Community Based Services (HCBS) coverage as follows:
Effective September 1, 2020:
- The definition of a Licensed Practitioner of the Healing Arts (LPHA) for the purposes of determining risk factors for Children’s Waiver eligibility is expanded to include licensed practitioners who have the ability to diagnose within his or her scope of practice under the state law or who are under the supervision of another licensed practitioner of the healing arts who has the ability to diagnose within his/her scope of practice under State law.
- After a child is found to meet Children’s Waiver eligibility including the existence of a risk factor, the State will not require on-going documentation of the existence of the LPHA risk factor so long as the child is continuously eligible for the waiver (i.e., continues to meet target criteria and level of care criteria).
- The State will update the definition of Adaptive and Assistive Technology to remove references to service animals that are not consistent with the ADA. Note: the definition will continue to cover reimbursement for service dogs.
- The State will reduce payments for services by 1.5% on or after September 1, 2020 consistent with the approved state budget. Note: the State has already submitted an amendment to reduce payments for services by 1% on or after March 1, 2020 and by an additional 0.5% (for a total reduction of 1.5%) on or after April 2, 2020 consistent with the approved state budget.
- The State will update the provider specifications for Palliative Care: Massage therapy to include provider agencies meeting the inter- agency provider designation requirements.
- The State will update the practitioner qualifications for Palliative Care: Pain and Symptom Management to include a Registered Nurse licensed by the State of New York under the direct supervision of a Pediatrician or medical physician, board certified in Pediatrics
Written comments will be reviewed by email at BH.Transition@health.ny.gov or by mail to the address below. All comments must be post marked or emailed 30 days of this notice issued today, July 15, 2020.
For further information please contact: Department of Health, Office of Health Insurance Programs, 99 Washington Ave., One Commerce Plaza, Suite 720, BH.Transition@health.ny.gov (Source: HealthyMinds, Healthy Kids Campaign and specifically, the NYS Coalition for Children’s Behavioral Health).