Changes to Children’s Home and Community Based Services (HCBS) – Telehealth Respite Services
Effective Jan. 1, 2023, the New York State Department of Health policy flexibility allowed for Children’s Respite Services during the COVID-19 Public Health Emergency (PHE) will end.
EmblemHealth HCBS providers will be required to revert to the original guidance provided in the HCBS Manual:
- Respite services delivered via telehealth or telephonically to an individual or group may no longer be billed.
- All respite services must be delivered in-person, as remote delivery will no longer be allowed.
- Respite services may be delivered in a home or residence by qualified practitioners, out-of-home/residence by staff in community-based sites (e.g., community centers, camps, parks), or in allowable facilities.
- Billing for respite services must be based on in-person interactions with the enrolled child/youth.
Additionally, planned and crisis respite services may not exceed the 14-day (1,344 15-minute units) annual limit without medical necessity, which must be documented in the member’s record. EmblemHealth authorization must also be documented in the child’s case record. HCBS provided beyond these limits MUST be supported by medical necessity, such as documentation through a Licensed Practitioner of the Healing Arts (LPHA) attestation form. The HCBS Manual will be updated to provide additional guidance regarding the specific day/unit requirements.
JP #61060 01/2023
