2/19/14 N.Y. St. Reg. HLT-46-13-00006-A
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Amendment of section 86-1.44 of Title 10 NYCRR.
Statutory authority:
Public Health Law, section 3614(13)
Subject:
Episodic Pricing for Certified Home Health Agencies (CHHAs).
Purpose:
To exempt services to a special needs population from the episodic payment system for CHHAs.
Text or summary was published
in the November 13, 2013 issue of the Register, I.D. No. HLT-46-13-00006-P.
Final rule as compared with last published rule:
No changes.
Text of rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Reg. Affairs Unit, Room 2438, ESP Tower Building, Albany, NY 12237, (518) 473-7488, email:
regsqna@health.state.ny.usAssessment of Public Comment
The Department received one comment to this regulatory initiative. The response to Home Care Association of NYS (HCA) letter of December 17, 2013 follows:
1) In response to the comments from HCA that the OASIS – C assessment instrument does not adequately capture the needs of the overall Medicaid home care population, the Department has determined that in applying risk adjustment to a population it is important to use the same measurement set for all individuals in the analysis. The OASIS data set is being employed because its use is mandated for all CHHAs by the federal government and it is thus the best available data that covers all patients across all CHHAs.
2) In response to the comments about changing the current regulatory criteria used to determine the providers eligible to receive an episodic payment exemption or case mix adjustment, the Department has determined that the existing regulatory criteria continue to be effective in insuring adequate reimbursement for providers who serve a predominantly special needs non-geriatric and/or OPWDD patient population. The Department has determined that the existing regulatory criteria are adequate to insure services for this targeted population of high needs patients.
