MedicaidAdministrativeHigh impact
New York Medicaid: Change to Direct Home Care Worker claims
UnitedHealthcare·NY · Occupational Therapy, Physical Therapy, Geriatrics +1 more·State news
Effective date
Oct 1, 2026
We identified it
Sep 2, 2026
Summary
Starting October 1, 2026, all UnitedHealthcare Community Plan of New York Direct Home Care Worker claims must include the Home Care Worker ID as the rendering provider ID and be submitted exclusively through the HHAeXchange platform. Claims for home health aide, personal care, and CDPAS services submitted outside HHAeXchange after this date will be rejected.
Action Required
By September 30, 2026: Billing team must (1) update billing software to require Home Care Worker ID in the rendering provider ID field for all home health aide (HHA), personal care (PCA), and consumer directed personal assistance services (CDPAS) claims; (2) establish submission workflow through HHAeXchange platform exclusively for these service types; (3) train all staff on new submission requirements and verify HHAeXchange portal access; (4) remove or disable any alternative submission methods for these claim types in current systems. Update claim templates and encounter forms to capture Home Care Worker ID. Failure to comply will result in claim rejections on or after October 1, 2026.