Transitional Care for Personal Care Services Benefit

An Enrollee having an existing relationship with a Human Resources Administration ("HRA") Home Care Attendant Program Vendor or a Local Department of Social Services Personal Care Program Vendor ("Vendor") shall be permitted to continue receiving personal care services by any non participating Vendor up to sixty (60) days from August 1st with extensions by the plan as appropriate.

If the Enrollee elects to continue to receive care from a Non- Participating Vendor, such care shall be reimbursed by the MCO for the transitional period only if the Non-Participating Vendor agrees to:

  1. accept reimbursement from the MCO at rates established by the MCO, or in the case of Nassau, Suffolk, Westchester, at the FFS rate established by the State; or for the City of New York, at the rate established by HRA as payment in full; and
  2. adhere to the MCO's quality assurance requirements and provide to the MCO necessary health information related to such care; and
  3. otherwise adhere to the MCO's policies and procedures.