A new bill was introduced in the New York State Senate last week in an attempt to address recent changes made to the Consumer Directed Personal Assistance Program (CDPAP), which effective April 1, 2025, will allow only a single statewide fiscal intermediary (FI) to administer the program. The bill, if passed, would require that starting on April 1, 2026, no entity may provide FI services in New York without a license issued by the New York State Department of Health (DOH).
The bill represents a significant shift from the current system, where FIs, which among other things manage the wages and benefits of personal assistants servicing Medicaid beneficiaries who are chronically ill or physically disabled, can operate without formal licensure. In order to ensure there is no service interruption, the bill permits DOH to grant applicants temporary authority to continue providing FI services while their applications are under review. The DOH Commissioner is tasked with creating regulations to ensure a smooth transition for consumers and personal assistants if their current FI does not receive a license. Applicants will be charged a one-time application fee of $10,000.
The bill requires that applications be filed with the DOH Commissioner, who will approve them based on the character, competence and community standing of the applicants' personnel and operations. The Commissioner will also consider compliance with cost reports, cultural and language competencies specific to the population of consumers and the available workforce, electronic visit verification requirements, and demonstrated compliance with all applicable federal and state laws.
Licensed FIs will face strict reporting requirements under the bill, including detailed annual reports covering the direct care and administrative costs of personal assistance services, the number of Medicaid beneficiaries served, service areas, personal assistant employment details, hours worked and billed per consumer, consumer self-direction status and other information as required by the DOH Commissioner. Additionally, as a condition for participation in CDPAP, FIs would be prohibited from engaging in advertising unless it complies with regulations established by the Commissioner.
The bill also mandates the creation of a personal assistant registry, where FIs will be required to register all personal assistants employed by consumers under the program. Registration will be free, confidential, and used by DOH for oversight and fraud prevention.
Furthermore, the bill introduces minimum training requirements for personal assistants, covering essential knowledge and skills tailored to consumer care needs and the assistant's qualifications. Training programs will be free, available in person or online, and FIs must certify that personal assistants have completed the required training unless they qualify for a waiver of the training requirements pursuant to regulations developed by DOH.
The bill also grants the DOH Commissioner broad regulatory and oversight authority, including the power to suspend or revoke licenses for noncompliance. For example, temporary suspensions may be imposed for up to 45 days without a hearing if public health or safety is at risk. The Commissioner will also have the authority to review contracts between FIs and related entities to ensure compliance with state and federal law. If any unlawful actions are discovered, the Commissioner will refer them to DOH and the Medicaid fraud control unit for enforcement.
The bill will not be heard until January 2025 when the legislature reconvenes, which is notably after the critical deadline of Oct. 1, 2024, for selecting the single statewide FI. Holland & Knight attorneys will closely monitor the bill's progress and related developments. You can read more about the present challenges faced by CDPAP in Holland & Knight's previous blog post, "CDPAP Legal Storm Continues: New Lawsuit Targets DOH's RFP Implementation, Single FI Structure," Aug. 19, 2024.
