NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines

What this rule requires your agency to do

• 1Payment for CDPAP services will not be made to a consumer's spouse, parent, or designated representative (and may be made to another relative only if that relative does not reside in the home or resides there solely because the amount of care required makes their presence necessary).(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)
• 2Prior authorization from the local department of social services must be received by the fiscal intermediary prior to initiation of CDPAP service delivery.(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)
• 3The consumer's spouse, parent, or designated representative may not serve as the consumer directed personal assistant.(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)
• 4No payment will be made for authorized services unless each claim can be supported by documentation of the time spent per day in provision of services for each individual consumer.(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)
• 5All fiscal intermediaries must have a contract/MOU with the local social services district, be enrolled as a Medicaid provider, and have rates established or approved by DOH to support fee-for-service CDPAP participants.(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)
• 6The designated representative may not be the personal assistant or a fiscal intermediary employee, representative, or affiliated person.(NYS Medicaid Consumer Directed Personal Assistance Program Provider Manual — Policy Guidelines)