DOH Makes CDPAP RFO Award Announcement

Today, February 11, the Department of Health (DOH/the Department) released the list of successful CDPAP RFO applicants and the counties that will be served.  
HCP has been in contact with DOH to investigate what the next steps are for Fiscal Intermediaries. 

DOH awarded 68 applicants out of the nearly 400 applications submitted. DOH has said that each county will have no fewer than 24 FIs. The counties in the NYC metropolitan area will have roughly 60 FIs.

Please be aware that the restricted period procurement period is still in place, and applies to those FIs that have been selected and not selected. No contact with DOH should be had at this point, except through the designated channel.  

“Restricted period” means the period of time commencing with the earliest written notice, advertisement, or solicitation of a Request for Offers (“RFO”), Invitation for Bids (“IFB”), or solicitation of offers, or any other method for soliciting a response from Offerors intending to result in a procurement contract with DOH and ending with the final contract award and approval by DOH and, where applicable, final contract approval by the Office of the State Comptroller.

The Department has outlined new transition policies for Fiscal Intermediaries (FIs) and Consumers under the Consumer Directed Personal Assistance Program (CDPAP).  These policies are contained in MLTC Policy 21.01. This policy supersedes and replaces MLTC Policy 20.01 originally issued on March 6, 2020.

It is important to note that the contract award process now will be undergoing a review process by the Office of the State Comptroller (OSC). This process could take as long as 60-90 days. HCP was told that the DOH will make an announcement once a sufficient number of FIs have had contracts approved by the OSC, at which time it will be necessary for all FIs to begin transitioning patients consistent with MLTC Policy 21.01.

MLTC Policy 21.01 provides transition guidance for current FIs that were not selected as a lead FI pursuant to Request for Offers (RFO) #20039.

The purpose of this policy is to facilitate the transition of services from entities currently providing FI services ("Current FIs") that will be required to cease operations following the issuance of awards under the RFO. This policy is effective immediately and provides guidance primarily to Current FIs, Local Departments of Social Services (LDSS), and Managed Care Plans for required consumer transitions resulting from the Department´s announcement of the entities selected to provide FI services as a result of the RFO, and the Department´s upcoming announcement of the "Contract Notification Date" which is defined as the date the Department first publishes on the RFO web page a list of Lead FIs that have contracts executed by the Office of the New York State Comptroller (OSC) resulting from awards under the RFO.

For ease of use, this policy is divided into two scenarios. In each scenario, the process, timeframes and responsibilities for Current FIs and other entities regarding how to cease operations are different. The two scenarios are as follows:

1. Current FIs that were not awarded a contract that elect to cease FI operations prior to the Contract Notification Date as defined above (p. 3); and
2. Current FIs that were not awarded a contract that elect to continue FI operations until the Contract Notification Date as defined above (p. 5).

Within these two scenarios requiring Current FIs to cease operations, there are three types of Current FIs that will have to transition consumers to Department contracted Lead FIs depending on their actions taken under the RFO, as follows:

1. Current FIs that submitted an offer under the RFO as a Lead FI and were not awarded a contract;
2. Collaborating Partners of contracted FIs; and
3. Current FIs that did not submit an offer as Lead FI under the RFO, nor were a Collaborating Partner in any offer made in response to the RFO.

Questions regarding these FI transition provisions should be directed to the Department of Health at ConsumerDirected@health.ny.gov.

Scenario 1: Current FIs that were not awarded a contract as a Lead FI and Elect to Cease Operations Prior to the Contract Notification Date

Transition Policies and Procedures

Current FIs that were not awarded a contract as a Lead FI and do not want to continue operations through the Contract Notification date must deliver written notice at least forty-five (45) calendar days before discontinuing operations to the affected CDPAP consumers (or the CDPAP Consumers´ designated representatives), the CDPAP Consumers´ personal assistants (PAs), the LDSS and Managed Care Plans with which the Current FI contracts, and the Department.

FIs must use the following templates, located on the Department´s CDPAS web page, to provide such written notices:

FI Cease Operations Template FI to Consumer
FI Cease Operations Template FI to LDSS or Managed Care Plan
FI Cease Operations Template FI to PAs

The templates include information regarding the date the Current FI plans to cease operations and the following information.

1. Notice to the CDPAP consumer (or the consumer´s representative) indicating the consumer has a right to select a new FI of their choosing, and that their Managed Care Plan or LDSS (as appropriate) will be contacting them to provide options for choosing a new FI as well as supervise and assist them with transitioning to a new FI. In addition, the notice indicates the Current FI has also notified their Managed Care Plan or LDSS, their PA(s), and DOH.
2. Notice to the CDPAP consumer´s PA(s) indicating the Current FI has notified their CDPAP consumer of the election to cease FI operations and the need for them to select a new FI. The notice also indicates the Current FI has also notified DOH, and the CDPAP consumer´s Managed Care Plan or LDSS, and that the Managed Care Plan or LDSS will supervise and assist with the transition process.
3. Notice to any LDSS or Managed Care Plan with which the Current FI contracts indicating the Current FI has notified their CDPAP consumer, the CDPAP consumer´s PA(s), and the DOH of their change in FI operations. The notice must identify each CDPAP consumer that has received the notification.
4. Copies of all notifications must be sent to DOH via a HIPAA compliant email to ConsumerDirected@health.ny.gov with the subject line: "FI Withdrawal Notices".

Within five (5) business days of receiving a records request, with written consent from the CDPAP consumer, FIs must transfer all records relating to the CDPAP consumer´s care authorizations to the consumer´s Receiving FI. Within five (5) business days of receiving a records request, with written consent from the CDPAP PA, a Current FI must transfer records related to the PA´s health status, including immunization records to the consumer´s Receiving FI. Upon transmittal to the Receiving FI, the current FI must acknowledge it assumes all liability for omissions or errors in such records.

The Model Consent Forms, also posted to the Department´s CDPAS web page, may be used by the consumer to provide written consent to transfer their records.

CDPAP Consumer Service Authorization Transfer – Model Consent Form
CDPAP Medical Record Authorization Transfer – Model Consent Form

Transition Requirements for Managed Care Plans and LDSS

Within five (5) business days of receipt of a notice from a contracted Current FI that they are ceasing operations, the Managed Care Plan or LDSS, depending on whether the CDPAS consumer is enrolled in Medicaid managed care or Medicaid fee-for-service, must send each affected member receiving CDPAP a written acknowledgement of receipt of the notice from the Current FI using the following templates located on the Department´s CDPAS web page.

FI Cease Operations Template Managed Care Plan or LDSS to Consumer
FI Cease Operations Template Managed Care Plan or LDSS to Consumer 2nd Notice

The templates include the following information.

A statement that the Managed Care Plan or LDSS has received notice of the change in their FI´s operations and is charged with overseeing and assisting the CDPAP consumer with selecting a new FI;
The CDPAP consumer has the right to select a new FI of their choice and the change in the Current FI´s business operations does not impact their care plan or their choice of PA(s);
A list of all other FIs, including contact information, the Managed Care Plan or the LDSS contracts with and operates in the member´s service area;
To ensure continuity of FI services, a request that the CDPAP consumer select another FI within ten (10) calendar days from the date the CDPAP consumer receives the CDPAP consumer notice;
A contact at the Managed Care Plan or LDSS, including a telephone number, to address CDPAP consumers´ questions or concerns; and
A reminder that CDPAP consumers are entitled to a copy of their care plan, and instructions on how the consumer may obtain a copy of their care plan.

As part of the Managed Care Plans and LDSS role in supervising the transition to a new FI, Managed Care Plans and LDSS will oversee the transfer of records by the Current FI to the Receiving FI and maintain regular contact with CDPAP consumers to ensure services from the Receiving FI are in place prior to the change in operations noticed by the Current FI.

Within five (5) business days of the requested 10-day period provided to CDPAP consumers to select a new FI, Managed Care Plans and LDSS, shall issue a second notice and contact the member directly to notify and assist them with selecting a new FI. Managed Care plans and LDSS should continue to follow up with CDPAP consumers until the transition to a new FI is complete.

Scenario 2: Current FIs that were not awarded a contract as Lead FI but Elect to Continue Operating until the Contract Notification Date

To ensure continuity of care and an orderly and efficient transition for CDPAP consumers that may need to select and transition to a new FI, the Department will permit all Current FIs that were not selected as a Lead FI to continue to serve CDPAS consumers for no longer than 90 calendar days after the Contract Notification Date at which time the Current FI will have to cease operations. Under the provisions of Section 365-f of the Social Services Law, the Department, rather than the Current FI, will issue the following notifications (also identified above), to consumers or their designated representatives, PAs, LDSS and Managed Care Plans that the Current FIs must cease operations and transition consumers to Department contracted FIs:

The Department will work with Current FIs, and the Managed Care Plans and LDSS who are responsible for supervising the transition of consumers to a new FI, to obtain the information required for the Department to effectuate initiating notices to the required parties.

The Department may issue additional transition policies and procedures and notices to draw on the ability of the Managed Care Plans and LDSS to assist before or during the 90-day period following the posting of contracted FIs to the website to ensure seamless continuity of services for CDPAP consumers.