Provider Readiness & Training
- Behavioral Health Medicaid Managed Care Kickoff Forums
- Managed Care Kickoff PowerPoint slides
- Recorded Version of the 10/6/2014 Kickoff Forums
OASAS in collaboration with: The State Office of Mental Health (OMH); Department of Health (DOH); and, the New York City Department of Health and Mental Hygiene (NYC DOHMH) is pleased to announce a series of Behavioral Health Medicaid Managed Care Kickoff Forums. To assist behavioral health providers with the transition to a managed behavioral health benefit, New York State has contracted for a Managed Care Technical Assistance Center (MCTAC) . MCTAC will be led by NYU's McSilver Institute in partnership with the National Center on Addiction and Substance Abuse (CASA) at Columbia University . MCTAC will provide tools and trainings that will assist providers in improving business and clinical practices, as they transition to Medicaid managed care. The kickoff forums are the beginning of that effort. All New York State behavioral health providers serving adults and children are invited to register to attend and are encouraged to send administrative, fiscal, and clinical senior executive leadership representatives to attend one of the Kickoff Forums to learn more about the upcoming changes in Medicaid managed care. These additional dates are located in the downstate region and the state is actively working to schedule additional forums for the rest of the state.
- OASAS in collaboration with: The State Office of Mental Health (OMH); and, the State Department of Health (DOH) is pleased to announce that three dates have been added to the Behavioral Health Medicaid Managed Care Kickoff Forums . Pre-registration is required . These additional dates are for trainings located in: Binghamton, Buffalo, and, Syracuse. These dates are in addition to the previously posted October 6, 2014 Albany training date .
- Provider Readiness Recorded Webinar - On May 22 and May 29, 2014, OASAS General Counsel, Rob Kent, delivered a webinar on provider readiness for managed care, OASAS specific initiatives and the Delivery System Reform Incentive Payment Program (DSRIP).
- Statewide Provider Readiness PowerPoint
- Managed Care Organization Directory - Directory for New York State by County and Alphabetically by Plan
Readiness Checklist for the Move to Managed Care
General Readiness Points to Consider:
- Billing Software and/or Billing Vendor can submit clean claims to various plans.
- Billing staff knows the managed care plans in the region and have current commercial contracts or contacts within the managed care behavioral and physical health divisions.
- Clinical staff is aware of medical necessity criteria and utilization review expectations.
- The program has identified how it will communicate to plans utilization review, contract issues and billing.
- Clinical program staff have conducted a review on current service delivery
with a focus toward marketability:
- Are services provided medically necessary?
- What outcomes does the program currently have? How is the program working to improve patient outcomes?
- Does the program focus on efficient use of resources? There will be a shift in focus from volume driven payment in a fee-for-service environment to value driven payment.
- How is the program preparing?
- Do you offer unique services, serve a difficult or unique population?
- Are you able to engage and retain patients?
Comprehensive Medicaid Managed Care Readiness Self Assessment Tool
Programs are encouraged to utilize the Medicaid Managed Care Readiness Self-Assessment Tool. This is a voluntary tool to facilitate provider readiness for Medicaid Managed Care. Providers should not submit the Self-Assessment Tool results to OASAS, but may choose to submit results to Managed Care Technical Assistance Center (MCTAC) to help inform future training sessions.
- Medicaid Managed Care Readiness Self-Assessment Tool webinar - a short, informational webinar that covers the basics of provider readiness, some frequently-asked-questions and additional information on the Medicaid Managed Care Readiness Self-Assessment Tool.
Home and Community Based Services (HCBS)
- HARP eligible enrollees will have the ability to access an enhanced benefit that includes an array of HCBS services.
- Please be advised that incorporation of HCBS services into HARP plan networks will not begin until all CMS approvals have been received.
HCBS Provider Manual - Describes HCBS services as well as the basic requirements for any entity that is interested in providing HCBS behavioral health services within New York's public behavioral health system.
- Please be advised that the service definitions described in the manual are subject to change based on The Centers for Medicare and Medicaid Services (CMS) approval of the 1115 waiver.
HCBS Designation Requirements
- In order to participate as an HCBS provider within a HARP's network, programs must be designated as eligible to provide HCBS services and contracted by the plan to deliver HCBS services to its enrollees.
- All programs wishing to provide HCBS services must apply to be designated for each service they propose to offer and attest to meeting the staffing and service delivery criteria as outlined in the manual.
- NYC Home and Community Based Services (HCBS) Provider Designation List Now Available - The linked spreadsheet contains the names of NYC providers designated to provide HCBS, along with which service(s) they have been designated to provide. Each provider listed has gone through the HCBS designation process established by New York State. Please note, although NYC HCBS service providers have been designated, HCBS services are pending final CMS approval.
- HCBS Provider Applications for the rest of the state will be forthcoming.
- More information about the HCBS designation process will be shared to our providers as it becomes available.
Questions regarding Home and Community Based Services can be emailed to PICM