NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines

What this rule requires your agency to do

• 1All PCS must be provided in accordance with the prior authorization; reauthorization is required before any change in service function or hours or substitution of providers.(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)
• 2All persons providing personal care services must be subject to an ongoing program of supervision consisting of both administrative supervision and RN nursing supervision (including an initial orientation visit with the patient and worker).(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)
• 3PCS providers must be licensed or certified as a home care services agency by DOH, have a contract with the local social services district, be enrolled as a Medicaid provider, and have DOH-established/approved rates.(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)
• 4No payment will be made unless each claim can be supported by documentation of the time spent per day in provision of services for each individual patient.(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)
• 5Failure to capture EVV data may result in termination by the Department.(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)
• 6Beginning January 1, 2021, all providers of Medicaid-funded PCS must select and put into production use an EVV system meeting the 21st Century Cures Act requirements and submit required data to the State's EVV data aggregator.(NYS Medicaid Personal Care Services Program Provider Manual — Policy Guidelines)