NYS to Push Back Timelines for Children's Managed Care Transition Update

The State interagency partners from DOH, OCFS, OMH and OASAS are meeting with the Children’s Health and Behavioral Health MRT Subcommittee in New York City today. During our meeting, we will discuss the timeline for the children’s system design and transition to Medicaid Managed Care.

The State team is continuing to make good progress on finalizing the details of the design, but more time is needed to accomplish the implementation tasks and approvals required to ensure a smooth transition, including:

      • Feedback from CMS on Conflict of Interest and its Impact on 1915(c) Waiver Transitions and the overall children’s design;
      • State Plan and 1115 CMS Waiver Approvals;
      • Request for Qualifications (RFQ) for Medicaid Managed Care Plans (draft and final);
      • Readiness and Training Activities for Plans, Providers, and Stakeholders;
      • Designation of SPA and HCBS Providers;
      • Work to transition the Foster Care population including “residual per diem”;
      • Stakeholder Collaboration; and
      • Assess costs and how to accomplish the design elements within Global Spending Cap.

Six new SPA services will be implemented initially in the Fee-for-Service payment system for members in Fee-for Service or Medicaid Managed Care enrolled. The State is continuing to work towards a January 1, 2017 launch, but will continue to assess issues that may arise with implementing these services just ahead of the remaining transition.

NYC/LI - July 2017

    • SPA services (existing and new) will move to Medicaid Managed Care (MMC)
    • Children’s Home and Community Based Services will move to MMC
    • Children in the care of Voluntary Foster Care Agencies (VFCA) will move to MMC
    • Existing Children’s 1915(c) Care Coordination will transition to Health Home

ROS – January 2018 will be the same transition for the Rest of State.

There will be more information forthcoming through the State agencies and the Managed Care Technical Assistance Center (MCTAC) in the coming months. The State team looks forward to continuing to work with you to make this transformation a reality for New York’s children and families.

Angela Keller, LMSW

Director, Bureau of Children’s Program Design, Policy & Planning

Division of Managed Care

Office of Mental Health

44 Holland Avenue, Albany, New York 12229

(518) 473-6903 / FAX (518) 473-4690