Approved Reasons and Processes to Correct CANS-NY Errors within the UAS-NY

  • Document is also available in Portable Document Format (PDF)

The following outlines the approved process and the indicated errors that might occur by an assessor that would need to be corrected due to the impact upon billing and transmittal to the MAPP HHTS.

Entering a "First Time" CANS–NY and Selecting the Correct Assessment Type and Health Home
  1. To enter a first time CANS–NY for the Health Home program within the UAS–NY, it is necessary for ALL children to be FIRST referred through the Health Home MAPP HHTS Referral Portal and an enrollment segment completed prior to completing a CANS–NY within the UAS–NY. By creating an enrollment segment, the HH Care Manager (CM) will have the Health Home information that is NECESSARY to match within the CANS–NY for the member. Once the HH CM can verify the Health Home assignment for the member, then the CANS–NY can be entered and completed within the UAS–NY by signing and finalizing the assessment. REMINDER: The Functional Assessment Consent Form 5230 and Health Home Enrollment Consent Form 5200 or 50555 are necessary for the completion of the CANS–NY and enrollment segment.

    PLEASE NOTE: If the MAPP HHTS selected Health Home for the member does not match the Health Home on the CANS–NY for the member, you will not be able to bill for the assessment or acuity level. The entire CANS–NY Assessment for the member will have to be recompleted, as the assessment CAN NOT be deleted and/or edited once signed and finalized.
  2. It is necessary to choose the correct CANS–NY Assessment Type for billing and for tracking the CANS–NY information. All initial CANS–NY for Health Homes, the Assessment Type should be CANS–NY Assessment upon Enrollment.

    PLEASE NOTE: Completing a CANS tool for another program other than Health Home, does not correspond with the CANS–NY developed for the Health Home program (unless your agency is a NYC VFCA IV–E program). Therefore, Reassessment or Existing CANS–NY Assessment Types SHOULD NOT be selected for the initial Health Home CANS–NY. The Assessment Type selected should be CANS–NY Assessment upon Enrollment, which also triggers the one–time only CANS–NY assessment fee. The entire CANS–NY Assessment for the member will have to be recompleted, as the assessment CAN NOT be deleted and/or edited once signed and finalized.
Process to Correct CANS–NY Errors within the UAS–NY

When selecting the incorrect Health Home in a CANS–NY, which does not match the Health Home assignment in the MAPP HHTS, or choosing the incorrect assessment type for appropriate transmittal to the MAPP HHTS for billing, the following process should be followed:

  1. Contact the Lead Health Home and inform the agency that there is an incorrect CANS– NY Assessment that needs to be recompleted
  2. Once authorized to proceed by the Lead Health Home, print the completed incorrect CANS–NY Assessment to utilize as a guide to complete a new/corrected CANS–NY Assessment, with IDENTICAL responses
  3. Complete the new CANS–NY Assessment with the corrected choice of Health Home and/or Assessment Type
  4. The CANS–NY Assessment responses and acuity MUST be identical to the previous CANS– NY (This process CANNOT be utilized to change acuity outcomes or when there is a change of circumstances for the member)
  5. The new CANS–NY should be recompleted immediately upon recognizing an error with selecting the incorrect Health Home, assessment type and/or transmittal to the MAPP HHTS
  6. The Lead Health Home will be responsible to review and ensure that the process is completed accurately and that CANS–NY responses and acuity are identical.

PLEASE NOTE: That if you have completed a CANS–NY with the assessment type of CANS–NY Assessment upon Enrollment more than once with the same Health Home identified, without breaks in service and transmitted to the MAPP HHTS, then you MUST notify the Health Home immediately so that the one–time only assessment payment will not be billed twice.

The following are the various CANS–NY Assessment Types and Purpose:
  • CANS–NY Assessment upon Enrollment: used for any child newly enrolled in a Health Home
    • for both the initial time the child receives services in their lifetime and also when the child transfers from one HH into a new HH. This assessment type triggers the one–time only assessment payment in the MAPP system.
  • CANS–NY Re–assessment at 6 months: used for the standard reassessment period for any child enrolled in a HH and receiving continuous services
  • CANS–NY Re–Assessment Prior to 6 month: used when a child has a change of circumstances within 6 months of the last CANS–NY conducted that warrants an early new assessment.
  • Existing CANS upon Enrollment: used for NYC VFCAs IV–E program that utilizes the same CANS–NY as Health Home, for children that have had a CANS–NY assessment conducted as a part of the foster care placement process
CANS–NY Algorithm and Acuity

The above noted process to correct a CANS–NY within the UAS–NY, cannot be utilized to change the acuity outcome of the algorithm.

Health Homes and Care Management Agencies must ensure the care plan and case records for members served, include supporting documentation for elements required by the standards for Health Home plans of care (POC), the CANS–NY Assessment and the Health Home Per–Member Per–Month (PMPM) care management acuity.

The Health Home algorithm and guidance surrounding supporting documentation was issued on October 12, 2016, Health Home Supporting Documentation for POC and PMPM Acuity Final

Once the CANS–NY Assessment tool is signed and finalized, it cannot be unlocked to change answers to questions or change the acuity score. The CANS–NY tool should be reviewed for accuracy prior to signing and finalizing. Those new to the CANS–NY Assessment tool might want a supervisor to review prior to finalizing. All ratings should be based upon supporting documentation, which will be requested and reviewed during a CANS–NY audit.

Health Home Serving Children
Division of Program Development and Management
New York State Department of Health
Office of Health Insurance Programs