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ANNOUNCEMENT

October 29, 2012

  

Hurricane Sandy Update: Two New Notices on Provision of Services in Shelters and Authorization, Eligibility Verification

 

The state Department of Health has issued two General Information System (GIS) notices to local social service district officials regarding the provision of home care services in shelters and implementation of specific authorization and eligibility verification processes during the state of emergency caused by Hurricane Sandy.

 

The text of these GIS notices are provided in full below, along with associated links (click the headers to access the notices in PDF format for your reference).

 

GIS 12 MA/028

 

The purpose of this GIS is to advise local departments of social services (LDSS) that personal care services and home health services may be provided by home care services agencies licensed or certified under Article 36 of the Public Health Law to Medicaid recipients who are otherwise eligible for personal care or home health services and who are temporarily residing in disaster emergency shelters.

 

Such services may also be provided to individuals with commercial insurance coverage temporarily residing in a disaster emergency shelter; however, each individual should confirm insurance coverage for such services.

 

Each local government should arrange for sheltering as appropriate for the needs of its community, including persons who require personal care and home health services.

 

Additional questions related to the provision of personal care services at alternate sites during an emergency may be directed to Margaret O. Willard at (518) 474-5888 and questions related to home health services delivery at alternate sites during an emergency may be directed to Rebecca Fuller Gray at (518) 478-1638.

 

Note: please also see the Dear Administrator Letter here. This letter, providing similar information, was distributed on the Health Commerce System today.

 

GIS 12 MA/029

 

The purpose of this GIS is to advise local departments of social services (LDSS) of the implementation of specific authorization and eligibility verification processes in effect during this State of Emergency.

 

Due to the potential impact of Hurricane Sandy, the Fee-for-Service Medicaid Program is implementing the following processes until the State of Emergency has ended. The State of Emergency will be determined by the Local Department of Social Services and the State.

 

  1. During the State of Emergency, Fee-for-Service Medicaid will relax Prior Authorization requirements for the provision of urgent services.
  2. Providers will not be required to request authorization to treat enrolled beneficiaries for the provision of urgent services and will be reimbursed accordingly.

 

In the event that telecommunication failures prevent access to the Medicaid Eligibility Verification System, the Medicaid ID card will suffice as eligibility verification. If access to the eMedNY system prevents real time claim adjudication, pharmacies should dispense emergency supplies as necessary.

 

Questions regarding this information should be referred to the CSC Call Center at 800-343-9000.