Health Facilities Cash Assessment Program
Home Care Agencies
Certified Home Health Agencies (CHHA) and Long Term Home Health Care Programs (LTHHCP) under Article 36 of the PHL, and all Personal Care Providers (PCP) both licensed and exempt, possessing a Title XIX (i.e., Medicaid) contract with a Local Social Services District for the delivery of personal care services pursuant to Section 367-i of the Social Services Law, are assessed a percentage on cash receipts from personal care services effective for the period April 1, 2009.
Required monthly reports must be filed electronically by obtaining an electronic filing account, with an assigned secure password, from the Office of Pool Administration. To file a Cash Receipts Assessment Report, go to the Office of Pool Administration web site and select Cash Receipts Assessment from the options menu.
HFCAP assessment rates can be found at: Assessment Rates and Schedules
CHHA
- Reporting Instructions for CHHA
- DOH-4412 - User ID Application for Electronic Filing (PDF, 63KB, 2pg.)
LTHHCP
- Reporting Instructions for LTHHCP
- DOH-4412 - User ID Application for Electronic Filing (PDF, 63KB, 2pg.)
PCP
- Reporting Instructions for PCP
- DOH-4412 - User ID Application for Electronic Filing (PDF, 63KB, 2pg.)
File Reports
- File Electronically - New York State Office of Pool Administration
- Certification Form (PDF, 19KB, 1 pg.)