REVISED - Implementation Date of New York Independent Assessor

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

April 15, 2022

TO:                 Medicaid Managed Care Organizations Local Departments of Social Services Planned Provider Associations Interested Parties

FROM:           Susan Montgomery, Director Division of Long Term Care, OHIP

SUBJECT:     REVISED - Implementation Date of New York Independent Assessor

In a letter sent and posted on March 4, 2022, the Department of Health (Department) provided direction on the implementation timeline for additional regulatory changes to 18 NYCRR §§505.14 and 505.28 that will take effect on May 1, 2022.

This letter is to provide notification that the implementation of the New York Independent Assessor (NYIA) for the initial assessment process will now take effect on May 16,2022. This short delay is necessary to effectuate all forms and notices used in the new assessment process.

In addition, the NYIA initial assessment process for those individuals seeking PCS or CDPAS through the immediate needs process at the LDSS and Mainstream, HARP and HIV-SNP enrollees seeking an expedited assessment will now take effect on July 1, 2022.

Per the March 4, 2022 letter, the new "initial assessment process" is defined as the community health assessment, medical exam and practitioner´s order, and, where applicable, the independent review process conducted by the New York Independent Assessor through contract between the Department of Health and Maximus Health Services, Inc., for those individuals newly seeking PCS/CDPAS and/or MLTC eligibility.

The independent assessment process for routine and non-routine reassessments for adults 18 and over, as well as the independent assessment process for children 4-17, for both initial assessments and reassessments, remains pended until further notice.

This letter is also posted to the Department´s MRT II website under Long Term Care. Please direct any questions on the information provided below to