Fiscal Intermediary

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What is a Fiscal Intermediary?

A New York fiscal intermediary is an entity that acts as a middleman between a government agency or program and the individuals or organizations receiving funds or services. This model is often associated with government-sponsored healthcare programs and other social service programs.
In the context of healthcare, a fiscal intermediary may be a private company that processes and manages financial transactions between healthcare providers and government payers, such as Medicare or Medicaid. These intermediaries play a crucial role in ensuring that funds are appropriately disbursed, claims are processed efficiently, and program regulations are followed.
New York Fiscal intermediaries can also be involved in managing funds for various government grants, subsidies, or other assistance programs. They help streamline financial transactions, ensure compliance with program requirements, and provide oversight to prevent fraud and misuse of funds.
The specific roles and responsibilities of fiscal intermediaries may vary depending on the program or government agency involved. In some cases, these entities may also provide additional support services, such as training and technical assistance to program participants.

Fiscal Intermediary Services

Offer assistance in understanding the eligibility requirements and application process for New York’s CDPAP program.
Supporting individuals entering the CDPAP program with recruiting, hiring, training, supervising, and terminating caregivers, if necessary, per CDPAP guidelines.
Helping to arrange backup coverage for caregiving services.
Coordinating and facilitating other necessary services related to home care needs.
Assistance in maintaining payroll records and managing administrative tasks associated with the program.
Reviewing and outlining responsibilities for each selected caregiver based on the clients personalized care plan.

Who Are We?

Eagle Eye Home Care is a New York based company specializing in providing assistance and support for individuals seeking access to the Consumer Directed Personal Assistance Program (CDPAP). Eagle Eye Home Care takes on the role of a New York fiscal intermediary with the goal of facilitating the process for individuals requiring home health care services to navigate the CDPAP program effectively.

Eagle Eye Home Care focuses on enabling individuals to manage their care by selecting, training, and directing their caregivers through the CDPAP program, a New York State Medicaid initiative designed to empower individuals with chronic medical conditions or physical disabilities to choose their own caregivers, including family members or friends. Eagle Eye Home Care offers a range of services aimed at assisting individuals in accessing and utilizing the CDPAP program effectively.

What is the role of a fiscal intermediary in New York for Medicaid CDPAP?

In the context of Medicaid Consumer Directed Personal Assistance Program (CDPAP), a fiscal intermediary in New York plays a crucial role in facilitating and managing the financial aspects of the program. CDPAP is a Medicaid program that allows individuals who require home care services to have more control over their care by allowing them to choose, train, and manage their own personal assistants, including certain family members. A fiscal intermediary (FI) is not able to make decisions regarding the amount or type of services one receives.

The role of a fiscal intermediary in New York for the Medicaid CDPAP program typically includes the following responsibilities:

New York Fiscal Intermediary Regulations

The most recent set of rules regarding becoming a fiscal intermediary was passed in December 2019. In 2019, the state of New York made it so that any FI that works with the CDPAP program must also be joint employers.

The state also passed regulations specifying the types of organizations that can become CDPAP a fiscal intermediary, which include:

Service centers and independent living centers
Institutions providing CDPAP services are grandfathered in and can continue providing CDPAP services

Organization Eligibility

If an organization is eligible, then it must follow a set of steps to become registered and authorized (Individuals cannot be FI; an FI must be a business, organization, non-profit, or some other kind of entity).
The business or organization must submit an application to the New York State Department of Health to get authorized. This application ensures that the business is the right kind of organization to be an FI.
Businesses or organizations that have their applications accepted must then contact the Bureau of Long Term Care Reimbursement and to open a Health Provider Network Account. If the organization is not already part of the Medicaid provider network, then it must reach out to the Bureau of Provider Enrollment at the Division of OHP Operations to get a provider ID number.
Once completed, the FI can get a Managed Care Organization (MCO) contract to provide CDPAP homecare. Now the FI can discuss wages, reimbursement terms, and agreement terms. FIs are not able to sign any MCO contracts until their application has been viewed by the Department of Health and authorized to act as a fiscal intermediary.

Are you seeking care?

If you are seeking care through CDPAP, it is important to know your rights and responsibilities as a consumer. The Fiscal intermediary program was structed to maximize your freedom and the licensing steps and requirements ensure that FIs are competent and able to provide the necessary services in accordance with the law.