If qualified for MLTC plan enrollment, the notice provided by NYIA will direct the member to contact the NYIA for information about available MLTC plans. Independent Practitioner Panel (IPP) - The regulations replace the requirement for a physician's order to authorize PCS and/or CDPAS with a requirement that these services are ordered by a qualified, independent practitioner, and expand the list of ordering practitioners to include Medical Doctors (MD), Doctors of Osteopathy (DO), Nurse Practitioners (NP) and Physician Assistants (PA) contracted to work for the Independent Practitioner Panel (IPP) under the NYIA. A Practitioners Order (PO) will be signed by IPP. Select the hand tool from the toolbar, place the hand pointer inside the first form field you want to complete, and click your left mouse button. Services covered through New York's 1915(c) Waivers, including the Nursing Home Transition and Diversion (NHTD), Traumatic Brain Injury (TBI) and the Office for People with Developmental Disabilities (OPWDD) Comprehensive Waiver, will not require a NYIA CHA. The date for those is still to be determined. Medicaid is implementing a change in the way assessments are done for community home care benefits. Those files include some computations and guidance in making certain entries. We provide the forms in either regular or fill-in formats. Sign up online or download and mail in your application. Select File, select Open, locate the form, and double-click on the saved form file name. The assessment helps us understand how a person's care needs affect their daily life. To mark a check box, click the left mouse button (click again to unmark it), or type an X in the box if nothing appears after clicking your left mouse button. The process, which is called the CHA Variance request process, can be initiated when the MMC plan identifies either one of two concerns: a mistake or a clinical disagreement. Clinical Appointment - The IPP clinician will conduct a clinical exam, review the CHA and any supporting documents, and issue a Practitioner Order (PO) for PCS and/or CDPAS. (See timeline below.) Current recipients will be grandfathered in. The arrow pointer or pointing finger allows you to select a field, a check box, or an item from a list. Annual reassessments and requests for increases by MLTC, managed care plans and local districts will not be done through the New York Independent Assessor system yet. NYIA registered nurses conduct a UAS assessment of these individuals to determine whether they qualify for these services. See 18 NYCRR 505.14(b)(4)(vi) and 505.28(e)(4). Improve health outcomes in today's complex world, Modernize government to serve the needs of citizens, Empower vulnerable populations to succeed, Meet expectations for service and ease of use, Leverage tax credits, recruit and retain qualified workers, Provide conflict-free health screenings and evaluations, Resolve benefit disputes with a nonjudicial approach, Modernize your program, adapt to changing needs, Make services easier to access, ensure program integrity, Creating a positive impact where we live and work, Recognized by industry and media for making an impact. 103 0 obj <>/Filter/FlateDecode/ID[<466FD9BA560342CE95011ED96A1EE776>]/Index[65 78]/Info 64 0 R/Length 149/Prev 63200/Root 66 0 R/Size 143/Type/XRef/W[1 2 1]>>stream If there are transfers or withdrawals made where the applicant did not receive fair market value Medicaid will impose a penalty period before Medicaid will begin paying for services. However, individuals will continue to be reassessed upon a change in medical condition, upon release from institutional care, or upon their request (non-routine reassessments) and before their current assessment expires (routine reassessment). If the member refuses the new CHA, the MMC plan must use the CHA on file in developing the plan of care and authorization. Am I Eligible for Community Based Long Term Services and Supports? %/L}Q_&wv>UF\n1 <>/Metadata 2064 0 R/ViewerPreferences 2065 0 R>> 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. Serving all of New York City including, but not limited to, the following localities: NYC including New York County (Manhattan); Bronx County; Kings County (Brooklyn); Queens County including Astoria, Bayside, Flushing, Forest Hills, Fresh Meadows, Kew Gardens, Long Island City, Middle Village, Queens Village, Rego Park, Ridgewood, Whitestone, Woodhaven, and Woodside; Richmond County (Staten Island); as well as Nassau County including Garden City, Great Neck, Levittown, New Hyde Park, Syosset, and Westbury; Suffolk County; and Westchester County including New Rochelle and Yonkers. Simply click your left mouse button in the field you want and the cursor will return. 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. 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. 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, the Community Health Assessment (CHA) in the UAS-NY, New Yorks comprehensive assessment for State Plan CBLTSS, conducted by a Registered Nurse; and, a clinical exam, conducted by a clinician on an Independent Practitioner Panel (IPP) under the New York Independent Assessor (NYIA); and. November 1, 2021 - Letter Announcing Implementation Dates for PCS/CDPAS Regulatory Changes. For standard requests, the MMC plan will no longer conduct a separate CHA to authorize PCS and/or CDPAS. Both the appellant and the MMC plan may call NYIA as a witness to any case regarding the challenge of a determination of services where the MMC plan relied on the CHA, PO, or IRP recommendation provided by NYIA. If the NYIA determines the individual is not medically stable, then the notice from NYIA will include conference and fair hearing language. These members will also be instructed to contact their MMC plan for next steps. To allow for sufficient space in a field for typing characters, please avoid using all capital letters. It has been in continuous use in NYS since 2011 and is not changing based on the revised statute or regulation. You can expect prompt and courteous customer service from our Helpline counselors. This assessor will replace the Conflict-Free Evaluation. For members seeking services within the MMC plan, upon completion of both the CHA and the PO, the individual will receive a notice form NYIA indicating whether their health condition is stable to receive PCS and/or CDPAS in their home. See 18 NYCRR 505.14(b)(4)(viii) and 505.28(f)(3). This is a unique opportunity to build your career with a great company thats making a difference in the lives of New Yorkers in need of vital services. Independent Review Panel (IRP) - An independent panel of clinicians under the NYIA that will provide a secondary medical review for high needs cases and issue a recommendation to the LDSS or MLTC plan regarding whether the proposed plan of care is reasonable and appropriate to maintain the individual's health and safety at home. iFf -}Oly9-"CT2|0 Y Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Complete the interest form and you will be contacted by one of our agency partners to discuss current opportunities. Even if a PDF file indicates that you may sign it electronically, the Tax Department does. endobj Requests for PCS and/or CDPAS made on an expedited basis will continue to be made by the MMC plan until July 1, 2022. nyia assessment request form pdf new york state property assessment guidelines nyia assessment request form 0522 tax commission nyc tax commission forms nyc property tax appeal nyc request for review of property value form department of finance forms Ownership structure of the entity template Learn more Online Bill PaySCL Health Learn more Nwb44500 For standard requests, the MMC plan will no longer conduct a separate CHA to authorize PCS and/or CDPAS. Stay tuned for further updated from our team. Select "Save Target As" or "Save Link As.". See 18 NYCRR 358-4.2. xok0\I ? Plans must request the dedicated URL by emailing NYIAHPA@maximus.com and NYIA will reply providing the MMC plan with the dedicated URL. Hours covered by voluntary informal assistance or other services or programs do not count towards the high needs threshold and should not be included in the calculation. For security purposes, we request that members reset their password the first time they visit this new website. 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. Concerning this matter format to distanceassessment @ nait.ca at 800-779-4602 best to nyia assessment request form pdf the links below . The implementation date of the New York Independent Assessor is now anticipated to begin on May 16, 2022. The MMC plan remains responsible for authorizing PCS and/or CDPAS and other CBLTSS that may address the member's demonstrated needs to maintain their health and safety in the community. Plan of Care (POC) - a person-centered plan of care developed in consultation with the individual and their representative(s), if any, that reflects the individual's needs, preferences, and goals in receiving services to maximize independence and community integration and incorporates social and cultural considerations for the provision of care. This is an excellent opportunity for clinicians to exercise their management skills in a hands-on, collaborative, and dynamic work environment. endstream endobj 66 0 obj <>>> endobj 67 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/TrimBox[18.0 18.0 630.0 810.0]/Type/Page>> endobj 68 0 obj <>stream 0 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). Send cfeec evaluation request form via email, link, or fax. :hX1x|29:c@C-X.5n^,=~K0D{G>4n_Fuqn7.T&~NWY,/wMH^Hl#j'.wS0&PUpRCpj;&f0)+0]0&tG . 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. 4 0 obj Chapter 56 of the Laws of 2020 authorized the Department of Health (Department) to contract with an entity to conduct an independent assessment process for individuals seeking Community Based Long Term Services and Supports (CBLTSS), including Personal Care Services (PCS) and Consumer Directed Personal Care Services (CDPAS or CDPC Program CDPAP). 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. Requirements for authorizing continuous PCS and/or CDPAS or live-in 24-hour PCS remain unchanged from prior directives, except for the requirement for additional medical review by the NYIA IRP in the first instance once the NYIA is implemented. To obtain the latest version of the free Adobe Reader, visit theAdobe Web site. DOH is authorized to impose monetary sanctions pursuant to NYS Public Health Law 12 on an MMC plan for failure to coordinate with the NYIA in accordance with 18 NYCRR 505.14(b)(iv)(a)-(c) or if the MMC plan engages in abusive behavior that affects the coordination of the assessment process. hYko+"! I4mA$:WR~gHdv#C3IL! An assessment form can come in different types. 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. Reset password | Request Login NYIA Members and Board of Directors may use this form to log into the site: Once the NYIA OSU staff verify that the application for the variance process is complete, it is referred to a Quality Assurance Nurse. Active fields containing the blinking I-beam will not print their contents. How Do I Give My Health Care Providers Permission to Share My Health Information with the New York Independent Assessor? To: Medicaid Managed Care Plans, From: Office of Health Insurance Programs, Division of Health Plan Contracting and Oversight, Re: May 16, 2022 Implementation of New York Independent Assessor for Personal Care (PCS) and Consumer Directed Personal Assistance Services (CDPAS). Tax Class 1 Properties. The implementation of a 30 month look back period for home care has been looming over our heads through most of the pandemic. With versions prior to that you will only be able to save the blank form. See 18 NYCRR 505.14(b)(2)(iv)(d) and 505.28(d)(4)(iv). Copyright 2023 Maximus. This is Attorney Advertising. See 18 NYCRR 505.14(b)(iv)(c) and 505.28(d)(4)(iii). 2 0 obj Routine and non-routine reassessments will continue to be conducted by the LDSS and MCO until further notice. To determine the average, the MMC plan may add up the total number of hours they intend to authorize over the course of a week for which services are needed, and then divide by 7. TheNew York Independent Assessor (NYIA) programhas been established for New York State Medicaid members who want to receive community-based long-term services and supports. Ldss and MCO until further notice be contacted by one of our agency partners to discuss opportunities. Button in the way assessments are done for community Based Long Term services and Supports characters, please avoid all. Their password the first time they visit this New website if a PDF file indicates that you sign. 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