Barclay Damon
Barclay Damon

Legal Alert

New York State Department of Health Issues Request for Applications to Establish New or Expand Existing Certified Home Health Agencies

The New York State Department of Health (“DOH”) has issued a Request for Applications (“RFA”) whereby it will accept proposals to establish new or expand existing Certified Home Health Agencies (“CHHAs”) in New York State. This is the first time in many years that applications will be accepted to receive establishment as a CHHA, which is a licensed home health agency allowed to bill the Medicare and Medicaid programs.

Of paramount importance in the application process is for applicants to show “public need.” Applicants will have to show that approval of the application will facilitate implementation of Medicaid Redesign Initiatives to shift Medicaid beneficiaries from traditional fee-for-service programs to managed care, managed long term care systems, integrated health systems or similar care coordination models or that approval will ensure access to CHHA services in counties with less than two existing CHHAs, not including those operated by the county. Applications that facilitate Medicaid Redesign Initiatives, especially in areas of the state that have the highest number of Medicaid recipients receiving home health services, will be the Department’s highest priority and will be assessed prior to applications addressing access to services in counties with fewer than two CHHAs. Further, applicants must demonstrate how they will increase efficiency in providing home health services, and improve patient choice, access, and quality outcomes, such as reducing emergency room visits and hospital readmissions. Applicants must also show how fragmentation of health care delivery will be reduced through enhanced care coordination and a reduction in the instances of inappropriate utilization of services, showing how approval of the proposal will build access to efficient and effective community-based systems of care through the development of an integrated health care system or formal relationships that coordinate patient care.

Applications are due March 9, 2012 by 4:00 p.m. Applications submitted will be evaluated by the Department of Health and presented to the Public Health and Planning Council for final recommendation and selection. Applicants must also submit a complete Certificate of Need (“CON”) application and associated fees to the Department within 45 days of the due date of the RFA submission (April 20, 2012).

Hiscock & Barclay has extensive experience in assisting in the drafting of RFA responses and CONs for providers and in the licensure of home care agencies. Please contact Melissa Zambri, Chair of the Health Care and Human Services Practice Area, or any member of the Practice Area should you require assistance.