State Policy · NY
New York OPWDD Finalizes Updated Self-Direction Documentation Rules
New York's Office for People With Developmental Disabilities finalized revised administrative directives on Oct. 30 governing Individual Directed Goods and Services (IDGS) within its Self-Direction program. The updated guidance, ADM #2015-05R2 and a companion ADM #2019-07R, revises requirements for approval, payment, Medicaid reimbursement and documentation of IDGS, along with related Fiscal Intermediary service documentation standards. Individuals who self-direct their services and the Fiscal Intermediaries that support them must adjust their processes to comply with the new documentation and reimbursement rules. The law firm alert does not specify an effective date beyond the finalization date.
Why it mattersFiscal Intermediaries and self-directing individuals in New York's developmental disabilities Medicaid program must update documentation and billing practices to avoid reimbursement denials under the revised standards.