Hinken Associates, LLC

09/06/2026

This is for New York. However, even if you are not in New York, the application of CMS regulations have an impact on every home care agency.

This article is in regards a six-month moratorium on new applications to enroll as a Medicaid provider in New York State. The State has adopted CMS regulations, rather than impose additional requirements.

The "red tag" as I call it has to do with the high-risk agencies listed. Home care is one of them.

High-risk audits occur in 50 to 55% of providers affected. That being said, you must be audit-ready and carefully monitoring all the documentation regarding EVV.

Do you have EVV and other Medicaid audit forms to monitor your strengths and vulnerabilities?

NYS DOH announces a six-month moratorium on new Medicaid provider enrollments for high-risk categories, impacting pending applications, CHOWs, and healthcare transactions.

09/06/2026

New York State created a Social Care Network (SCN) to assist the public with resources and navigation for social care needs and services. An important initiative in order to get resources right to the client.

Read about NY's initiative, and see how your state is creating one, since every state will need to do so in order to receive funding from CMS.

redesigning the medicaid program in new york, social determinants of health, community based organizations, cbo, summary, datasets, indicators, new york state.

08/30/2026

So many changes in New York, as well as all the other states. Medicaid revalidation deadline in New York is August 31st, 2026 for a September 15th effective date.

This is part of a national portal from provider to state, to CMS for submissions and claims regarding Medicaid and Medicare clients.

In April, the Centers for Medicare & Medicaid Services (CMS) directed every state to revalidate Medicaid-enrolled providers within an accelerated 24-month window rather than the standard five-year cycle. The New York State Department of Health (DOH) submitted its revalidation plan and on July 27, 2...

08/30/2026

Decades of experience, a lifetime of knowledge. Legal experience as an expert witness and Expert in subject matter in New York State Supreme Court.

Home care consulting New York State. Corporate and regulatory compliance. Horizontal expansion of business and affiliated services

08/28/2026

Indiana home care agencies have a 1115 Waiver application in the comment phase. See the provisions of the article. Your agency must be eligible to meet state and federal requirements.

Also remember, your Medicaid ID re-authorization is taking place this fall in most states, so look out for those emails!

08/28/2026

Remember, as school starts, the uptick of viruses, including COVID will go up. For those with health care risks, flu shots will be available as of September 1st. Join us for discussions on home and community-based services. More about us: https://homecarenewyork.weebly.com/

08/15/2026

V.A. providers in Regions 1, 2 and 3, you should have been notified already:

Here is the **operational directive** you need to implement across your LHCSA, CDPAP, or home‑care network to ensure full compliance with the VA’s September 2026 precertification mandate.

VA Precertification ID — Mandatory Use on Every VA Client (Effective September 16, 2026)

Executive Directive for Agency Operations

1. Policy Requirement
Beginning **September 16, 2026, all VA‑authorized services routed through Optum (Regions 1–3) — and any TriWest services that adopt parallel rules — must include a VA‑issued Precertification ID before care is rendered.
- Claims without a valid Precertification ID will be denied.
- Retroactive authorization will not be granted.
- The ID must appear on all documentation, EVV records, care notes, and claims.**

2. Agency-Level Compliance Actions (Implement Immediately)

A. Intake & Eligibility
- Add a mandatory precertification field to:
- Intake forms
- Eligibility checklists
- UAS‑NY / care plan review workflows
- EVV client setup
- Intake cannot be completed until the Precertification ID is verified and logged.

B. Scheduling & Service Authorization
- No VA client may be scheduled until:
- Precertification ID is confirmed
- Authorization dates match the care plan
- Region routing (Optum vs TriWest) is validated

C. EVV & Care Documentation
- Configure EVV to reject clock‑ins for VA clients missing a precertification ID.
- Require caregivers to confirm the ID during onboarding.

D. Billing & Claims
- Billing software must include:
- Required precertification ID field
- Hard-stop validation preventing claim submission without ID
- Claims team must verify:
- ID matches the service authorization
- Dates of service fall within the approved window
- Region routing is correct

E. QA/QI & Compliance Monitoring
- Weekly audit of:
- All active VA clients
- Precertification IDs
- Authorization periods
- Denial logs
- Monthly compliance report to leadership.

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3. Staff Training Directive
All staff must be trained on:
- What the VA Precertification ID is
- Why it is now mandatory
- How to verify it
- Where it must appear in documentation
- How to escalate missing or invalid IDs

Training must be completed by August 31, 2026!!!!!!

4. Communication to VA Clients
Provide a standardized notice explaining:
- The VA’s new precertification requirement
- That services cannot begin without the ID
- How veterans can obtain or confirm their ID
- Who to contact at your agency for assistance

5. Compliance Statement for Your Agency
You can use this in your manuals, SOPs, or audits:

"Effective September 16, 2026, our agency requires a valid VA Precertification ID for every VA client prior to the initiation of services. This identifier must be documented in intake, EVV, care notes, and claims. No VA services will be rendered or billed without confirmed precertification."

If you need:
- Standard Operating Procedures
- fillable compliance checklist
- staff training material
- claims department workflow
- compliance memos

Reach out to me for my rates and scope of engagement. In my 4th decade in home care compliance as a nurse, auditor Expert Witness (NY Supreme Court) and Expert in Subject Matter (NY Supreme Court). 212-634-7901x703 or email: [email protected] Please put your company name on the subject line.

https://homecarenewyork.weebly.com/

Home care consulting New York State. Corporate and regulatory compliance. Horizontal expansion of business and affiliated services

08/15/2026

CMS is requiring re-validations of Medicaid providers across the U.S. Here is what New York is planning. Watch your states' Medicaid memorandums carefully. It's all about risk management.

In April, the Centers for Medicare & Medicaid Services (CMS) directed every state to revalidate Medicaid-enrolled providers within an accelerated 24-month window rather than the standard five-year cycle. The New York State Department of Health (DOH) submitted its revalidation plan and on July 27, 2...

08/14/2026

If you participate in ABA therapy as a provider or your clients do, important changes coming your way.

Important to read this document and then check it again on December 1st to see what YOUR state is implementing as far as changes. I always calendar release dates because there is usually a time for public comments to be added as well.

The Centers for Medicare & Medicaid Services (CMS) on August 4, 2026, issued the Applied Behavior Analysis Toolkit, a 174-page guidance document for...

12/25/2025

Have a wonderful Christmas holiday!