NYPTA Supports S6002-A8316
AN ACT to amend the public health law, in relation to the financial
responsibility for and reimbursement of payment for early intervention
services by the state
Letter of Support
Early Intervention update
The Nassau County Supreme Court ruled to preliminarily enjoin the enforcement of the DOH adopted regulations that would prevent EI evaluators from providing service to children in the EI Program, effective February 9, 2013. Children referred to the program on or after that date can be evaluated and treated by the same provider. DOH has filed an appeal. We will keep you updated on developments.
Dear NYPTA Member,
We need your help! As you may know, the State has already reduced reimbursement rates and imposed numerous mandates on physical therapist providers in the Early Intervention (EI) program. Once again, the Governor’s 2013 proposed budget includes program modifications to the Early Intervention program, which will make it more difficult for children and their families to access services.
In an effort to help all of our members that these changes will affect, We are asking that you please take the time to send this letter to your individual Assembly members and Senators. If you’re not sure who your Assembly and Senate representatives are, click on the following link:
Early Intervention – Proposed Changes to Public Health Law
As you may know, the New York State legislature passed a budget last week. As we reported previously, the Governor has proposed changes to the Public Health Law that would have made several changes to the Early Intervention Program.
If you took the time to call or write your legislators on this issue, please be assured that your activism was key in holding off some of the proposed changes that would have more negatively impacted EI providers. Thank you!
The legislature rejected some of the proposals, accepted some and modified others. The final outcome follows:
- require EI service coordinators to notify the Office of Persons with Developmental Disabilities (OPWDD) if a child may be eligible3 for OPWDD services;
- require that the EI service coordinator implement the Individualized Family Service Plans (IFSP) in a timely manner;
- remove State Education Department (SED) authority to approve EI providers for the Preschool Special Education Program;
- authorize an increase in the percentage of state aid reimbursement to municipalities for EI services with Division of the Budget (DOB) approval;
- authorize the Department of Health (DOH) to contract with a fiscal agent through a mini-bid process; and
- require providers submit claims through the fiscal agent
- remove the authorization for municipalities to contract with EI providers, require service coordinators to assume various responsibilities from the municipality, and require service coordinators to provide performance reports to the municipality by providing for municipal oversight of providers; and
- allow the DOH to approve EI providers and enter into agreements as necessary by requiring DOH to use best efforts to ensure adequate provider capacity in the EI program
- require EI program evaluators to belong to the provider network of the parents’ HMO or other insurer;
- authorize representatives of third party payers to attend IFSP meetings;
- require children enrolled in EI that are covered under a third party payer plan that provides coverage for EI services from a provider within such plan’s network except under certain circumstances;
- allow New York State to increase the percentage of state aid reimbursement to municipalities for EI respite services at the discretion of DOH and with DOB approval;
- require an arms-length relationship between an evaluator, service coordinator, and EI provider;
- require all approved evaluators and EI providers to maintain contracts with a sufficient number of insurers;
- require third party payers to make available an adequate number of EI service providers consistent with EI program enrollment and require third party payers to make the list of EI providers publicly available and to review it quarterly;
- require insurers to pay in-network provider rates negotiated between the provider and the insurer and require out-of-network providers to be reimbursed at rates set by DOH;
- prohibit third party payers from denying EI service claims; provide that covered EI services do not count toward and established maximum annual or lifetime monetary limit but be subject to an insurer’s policy or visit limitations;
- and to require insurance providers to provide municipalities and service coordinators with information on the extent of benefits within 15 days.