NYIA will complete the Community Health Assessment (CHA) to determine service needs and, where applicable, MLTC plan eligibility. The new NYIA process will involve a Community Health Assessment (CHA) or Independent Assessment (IA) by a registered nurse as well as a second step, consisting of an Independent Practitioner Panel (IPP) which includes an examination by a clinician a clinical appointment (CA) to determine the number of home care hours to be provided to applicants for Medicaid-covered individuals seeking personal care services (PCS), consumer directed personal assistance services (CDPAS) and/or Managed Long Term Care (MLTC) Plan enrollment. Maximus is hiring Registered Nurses to fill a variety of positions with the NYIA program. hbbd``b`$TqM@\aR b^cXHD y :H @& n)1 uKAb SL$XA0Rb^@@F10I?m 5 endobj Edit your cfeec online Type text, add images, blackout confidential details, add comments, highlights and more. 2023 Created By MAXIMUS Digital Solutions, About the New York Independent Assessor Program, Community Based Long Term Care Services and Supports. The implementation date of the New York Independent Assessor is now anticipated to begin on May 16, 2022. As of December 1, 2022, an MMC plan enrollee with an expedited assessment request for PCS and/or CDPAS must have their Community Health Assessment (CHA) and Independent Practitioner Panel (IPP) Practitioner Order (PO) clinical appointment conducted by the New York Independent Assessor (NYIA). There are many aspects that are still unclear and will be learned as more cases undergo this new process. If 12 hours or more are indicated or required, there will be another independent medical review required by an Independent Review Panel (IRP), another group consisting of at least two clinicians. If you happen to press the Enter or Return key, you may temporarily lose your cursor. 142 0 obj <>stream nyia assessment request form 0522berlin-brandenburg academy of sciences and humanities. You need the free Adobe Reader 6.0 or higher to view and print the tax forms. MMC plans remain responsible for defending their decisions as the proper party to the fair hearing, including preparing materials to be presented at fair hearing ("evidence packet") and for providing these materials to the appellant or the appellant's authorized representative upon request. Now, working with a Dcss 0522 takes a maximum of 5 minutes. They will indicate whether there is a need for services and whether they believe that the individual is medically stable to receive PCS and/or CDPAS. The POC should be updated and documented at least every twelve months if continuing to meet the member's needs; or more frequently if the member's condition changes, at the request of the member, or as otherwise appropriate. Maximus seeks to fill multiple open positions on the NYIA and IPP teams, where you can play a critical role in helping some of the states most vulnerable people access services that can help them live longer, more fulfilling lives. ]I!mFY$N0[ZOH}#='Z5&CG <> is already in receipt of more than 12 hours a day, on average, of PCS and/or CDPAS as of the start date of the IRP, has had an IRP review and services are maintained at this higher level of care through subsequent proposed POCs regardless of whether proposed by the current plan, new plan or LDSS, and. Monday to Friday, 8 a.m. to 7 p.m. Saturday, 10 a.m. to 6 p.m., except for designated state holidays. On the call, the OSU coordinator schedulesthe . r5;-.D+n`P a1J*JPH(EikpA *2#iPQDkMt VBb8/y_~za_=#yGG70pNY>Bzt>uny0ks$v>+ 8 The assessment helps us understand how a person's care needs affect their daily life. NYIA registered nurses conduct a UAS assessment of these individuals to determine whether they qualify for these services. The CSR will proceed with scheduling a CHA and a clinical appointment upon verifying the consumer's identity, contact information, preferred assessment modality (telehealth or face-to-face) and, if needed, the location of an in-person visit. NYIA will provide a designated, secure URL for the MMC plan to submit the IRP review request. Send cfeec evaluation request form via email, link, or fax. hb```e``"y@ Y8~0, IaU_c|7oKr)~U,7-: A q@pTH X$//;+Lx64S^micyik:{$?H]fy3l >$T5$29-/# What Do I Need to Know About Assessments and Clinical Appointments? 01. Current recipients will be grandfathered in. This is a web-based form to be completed electronically through a secure URL. Operations Support Unit (OSU) - The interface between the NYIA and LDSS or Plans when referring a specific case for action such as an expedited or immediate need request, or a disputed assessment. During the Clinical Appointment, an IPP clinician will: The PO represents the clinical judgment of the practitioner. The implementation of a 30 month look back period for home care has been looming over our heads through most of the pandemic. hYko+"! I4mA$:WR~gHdv#C3IL! Where appellant is challenging the MMC plan's determination of PCS and/or CDPAS, these materials include, but are not necessarily limited to, the CHA, PO, IRP recommendation if applicable, POC, and any notices issued by the MMC plan to the appellant with respect to the action in question. Note, though, that applications filed before October 1, 2022 will not have a lookback period imposed. 3 0 obj Local Departments of Social Services: Click herefor information on how to assist clients to receive an Immediate Need Assessment with the New York Independent Assessor. Members of the Independent Practitioner Panel (IPP) conduct clinical appointments by telehealth and issue Practitioners Orders for Medicaid members who have been assessed as requiring personal care and other services. Policies and Guidance. This includes informing the NYIA when assessments or POs are needed and maintaining updated enrollment records in the UAS-NY so the reassessment notices go out automatically from the NYIA when reassessments are assumed by NYIA. has authorized hours above 12 previously and the hours are increased further, e.g., an increase from 16 to 24 hours. NYIA Schedules Appointment -MLTC Plan Enrollment To request an Immediate Needs Assessment, theLDSS must complete an Expedited/Immediate Need Assessment Request form via secure URL, then place a 3-way call with Fred and the NYIA Operational Support Unit (OSU) at 855-665-6942. It will be crucial to have an elder law attorney familiar with Medicaid assist you with navigating the new system. Let us know a convenient time to . (See "High Needs Review," below). After reviewing the CHA and PO, if the MMC plan has a material disagreement regarding the outcome of the independent assessment, the MMC plan may use the same NYIA CHA Variance Form to submit a material disagreement. Our state-specific browser-based blanks and complete guidelines eradicate human-prone errors. A. SECTION 1. Where these services and supports are available, MMC plans must authorize them, or discount them from the PCS and/or CDPAS authorization as applicable. If NYIA cannot reach a decision on whether such variance occurred due to insufficient or incomplete information, NYIA OSU staff will reach out to the MMC plan to obtain additional documentation. The new NYIA process will involve a Community Health Assessment ("CHA") or Independent Assessment ("IA") by a registered nurse as well as a second step, consisting of an Independent Practitioner Panel ("IPP") which includes an examination by a clinician - a clinical appointment ("CA") to determine the number of home care hours to be provided to applicants for Medicaid-covered individuals seeking personal care services (PCS), consumer directed personal assistance services . If you are unable to download and complete the form, email your name, address, telephone number and details of your child/children with a disabi Adobe Reader (or another program that can open and display PDF files)is required to view and print forms, instruction files, and any other PDF files found throughout this site. Services of more than 12 hours per day on average may be provided under a temporary POC. See 18 NYCRR 505.14(b)(4)(viii) and 505.28(f)(3). Also, eligibility for Personal care and CDPAP services and enrollment in MLTC will soon require the need for assistance for THREE Activities of Daily Living (ADLs) or dementia. October 26, 2022 information about environment cameron highland hiking trail. At the completion of the Clinical Appointment, the clinician will complete the PO, which will be uploaded to the UAS-NY. The NYIA process will take the place of CHAs currently conducted by the Local Departments of Social Services (LDSS) and Managed Care Organizations (MCO). If the NYIA requests the MMC plan to confirm or update the member's record in the UAS-NY, the MMC plan must respond within one business day and confirm or update the record within three business days. See 18 NYCRR 505.14(b)(2)(v) and 505.28(d)(5). GIS 22 MA/07 and Mainstream MC Guidance were posted on August 30, 2022 to delay implementation of the NYIA conducting initial assessments based on an immediate or expedited need for PCS and/or CDPAS to December 1, 2022. Customer Service Representative (CSR) - When a consumer initiates a call to the Helpline requesting a CHA, the NYIA call center representative (CSR) screens the caller to determine if an appointment should be scheduled. <> All rights reserved. The IPP is comprised of qualified, independent clinicians including Medical Doctors (MDs), Doctors of Osteopathy (DOs), Nurse Practitioners (NPs) and Physician or Specialty Assistants (PAs). ||}a|SSyKUMaBoyX~t_x^XzrExNO /WcR/^0M-{]Xz|[~{\lZ&;zc_g}Go_}aO!rtk=6y|*a;2H~My2_g]qwaeqywo`'.xLS):'2+xM6~-`!s]. The Department has contracted with Maximus Health Services, Inc. (Maximus) to implement the New York Independent Assessor (NYIA), which includes the independent assessment, independent practitioner panel and independent review panel processes, leveraging their existing Conflict Free Evaluation and Enrollment Center (CFEEC) infrastructure and experience. :hX1x|29:c@C-X.5n^,=~K0D{G>4n_Fuqn7.T&~NWY,/wMH^Hl#j'.wS0&PUpRCpj;&f0)+0]0&tG . The NYIA will continue to use this tool for the independent assessments. GIS 22 MA/09 - Implementation of Assessments Conducted by the New York Independent Assessor (NYIA) Based on an Immediate Need for PCS/CDPAS (PDF) The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. Practitioner Order (PO) - The Practitioner Order (PO) is the order form, which is required to authorize PCS and/or CDPAS, that must be completed by the IPP clinician after reviewing the CHA in the UAS-NY and determining if the individual is self-directing, or has an appropriate self- directing other, and can safely receive PCS and/or CDPAS at home based on their medical stability. Community Health Assessment (CHA) in UAS-NY. ATTORNEY ADVERTISING. Upon receipt of the IRP recommendation, the MMC plan will finalize the POC and issue an initial determination notice. November 1, 2021 - Letter Announcing Implementation Dates for PCS/CDPAS Regulatory Changes. A disagreement is material when it would affect the amount, type, or duration of services authorized. %PDF-1.5 % March 4, 2022 - Letter Announcing May Implementation Dates for Additional PCS/CDPAS Regulatory Changes. Caution:When using a public computer (library, computer cafe, etc. The NYIA includes an Independent Practitioner Panel (IPP) to conduct the exam that is now required to obtain PCS and/or CDPAS. The implementation date of the New York Independent Assessor is now anticipated to begin on May 16, 2022. They must be prescribed by an independent physician under contract with DOH, and approved by an independent assessor under contract with DOH instead of the local district Medicaid agency and MLTC plan. To be able to fill in and save any fill-in forms, you need Reader 11 or later; older versions do not allow userstosavea filled in form. The MMC plan is expected to submit a CHA Variance Form with due expediency upon discovery of a mistake or clinical disagreement. Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, James V. McDonald, M.D., M.P.H., Acting Commissioner, Multisystem Inflammatory Syndrome in Children (MIS-C), COVID-19 Excelsior Pass/Excelsior Pass Plus, Addressing the Opioid Epidemic in New York State, Drinking Water - Boiling Water and Emergency Disinfection Info, Health Care and Mental Hygiene Worker Bonus Program, Learn About the Dangers of "Synthetic Marijuana", Maternal Mortality & Disparate Racial Outcomes, NYSOH - The Official Health Plan Marketplace, Help Increasing the Text Size in Your Web Browser, Consumer Directed Personal Assistance Regulations, MMC Guidance - Process for Expedited Request for Assessment and the New York Independent Assessor (NYIA) -, MMC Guidance - ADDITIONAL REVISION Implementation Date for New York Independent Assessor (NYIA) to Conduct Assessments for Personal Care Services (PCS) and Consumer Directed Personal Assistance Services (CDPAS) on an Expedited Basis -, MMC Guidance - REVISED Implementation Date for New York Independent Assessor (NYIA) to Conduct Assessments for Personal Care Services (PCS) and Consumer Directed Personal Assistance Services (CDPAS) on an Expedited Basis -. Copyright 2023 Maximus. Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. We look forward to assisting you! Don't forget to hand sign any forms that require a signature and to keep a copy of your signed return for your records; see the return instructions for guidance on how long you need to keep these copies. Stay tuned for further updated from our team. Questions on this guidance can be sent to independent.assessor@health.ny.gov. If an MMC member began the initial assessment process prior to May 16, 2022, they will complete it with the MMC plan under the prior rules. Comply with our easy steps to get your Dcss 0522 well prepared quickly: Pick the web sample from the catalogue. Would affect the amount, type, or duration of services authorized assessment of these individuals to whether... Electronically through a secure URL will: the PO, which will be learned as more undergo! 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