NYS DOH Publishes DAL HCBS 14-01: Home Health Services in Managed Care Plans

Shelley Sabo in NYSCAL Notes

The Department of Health published DAL HCBS 14-01 in response to numerous questions received by the Department related to licensed or certified home health agencies that provide home health services through agreements with Medicare and Medicaid managed care plans.  The DAL is intended to provide guidance and clarification to both managed care plans and home health providers.

The guidance provides clarification as to what provider type (CHHA, LTHHCP, LHCSA) may provide home health services to Medicare/Medicaid beneficiaries when these individuals are enrolled in a managed care plan or managed long term care plan.  THE DAL cites the State Operations Manual (SOM) containing official policy guidance issued by the Centers for Medicare and Medicaid Services pertaining to Medicare and Medicaid programs.  The SOM contains official guidance related to services provided to both Medicare and Medicaid patients including home health services provided under the Medicaid home health benefit provided to Medicaid beneficiaries enrolled in managed care plans.

NYSCAL strongly encourages its members to read the DAL in its entirety.  The DAL may be found on the NYSCAL website, www.nyscal.org, or on the HCS portal.