Comprehensive Home and Community-Based Services (1915-c HCBS) Waiver
The Home and Community Based Services Waiver is the Medicaid program that provides opportunities for adults and children with intellectual and developmental disabilities to receive services in their own home or community.
Draft Waiver Amendment
Draft April 1, 2021 Waiver Agreement Public Comment Period
The Draft April 1, 2021, Waiver Amendment was posted to the OPWDD web page on November 10, 2020 for public comment. Written comments will be accepted from November 10, 2020 through December 18, 2020 and may be submitted by mail to: OPWDD, Division of Policy and Program Development, 44 Holland Ave., Albany, NY 12229 or by e-mail to: [email protected].
OPWDD conducted two webinars on November 12, 2020 to provide an overview of the proposed changes included in the Draft April 1, 2021 Waiver Amendment.
Current Waiver Agreement
Previous Waiver Agreement
Day Services Retainer Program
Last Eligible Day for Claiming through the Day Services Retainer Program is July 21, 2020
Providers that have opted to participate in the OPWDD Day Service Retainer Program
Please note: this guidance does not address retainer payments for Community
Habilitation services delivered by ‘self-hired’ staff and paid by Fiscal Intermediary
agencies as part of a person’s self-directed budget.
Based on recent federal guidance in which CMS limited the number of retainer days
that providers are allowed to bill, the last service date for submitting retainer day claims
to eMedNY under the Day Service Retainer Program is July 21, 2020.
This program was announced in a memorandum from DOH Deputy Director
Donna Cater, dated 06/05/20, and provided retainer payments to agencies that signed
an attestation, agreeing to the program’s rules of participation. We fully understand
that agencies did not anticipate this end-date for the program. OPWDD and our state
agency partners are examining options to address the ability of agencies to continue to
support individuals and families.
Please note the following:
- If your agency has signed and submitted to OPWDD the Day Service Retainer Day program Attestation, then you may continue to submit retainer day claims (using revenue code 0180) to eMedNY for service dates of April 18, 2020 through July 21, 2020. Retainer day claims are subject to the requirements of the Day Service Retainer program and guidance.
- This guidance does not affect the ability of Supervised Individualized Residential Alternative Agencies (IRAs) to deliver and bill eMedNY for Group Community Habilitation-Residential (Group CH-R)for individuals who live in the Supervised IRA and participated in another agency’s Day Habilitation or Prevocational Services. The authorized provision of Group CH-R services continues to be eligible for claiming to eMedNY.
- Agencies that participate in the Day Service Retainer Program may continue to deliver and bill Medicaid for alternate services as documented in the person’s Life Plan. For example, delivering Community Habilitation to individuals who live with their family and participated in your agency’s Day Habilitation program prior to the onset of COVID-19.
- Agencies continue to have the flexibility to deliver remote services per
guidance available on the coronavirus guidance webpage.
Post Day Service Retainer Program Flexibilities for Day Habilitation & Site Based Prevoc Providers
The following resources have been developed to assist providers to deliver services that meet the needs of individuals with intellectual and developmental disabilities during the COVID-19 emergency period.
Reference Page of COVID-19 Program Flexibilities for Supervised Individual Residential Alternative (IRA) Residential Habilitation, Day Habilitation, Community Habilitation, Site-Based Prevocational Services Providers and Community Based Prevocational Services Providers