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Behavioral Health Transitioning to Managed Care - Initial HCBS Provider Manual

The Department of Health (DOH) and other state agencies have released the initial version of the Home and Community Based Services (HCBS) Manual. The manual will be used as a basis to begin the HCBS designation process for HCBS providers in NYC as part of the transition of behavioral health services into Medicaid Managed Care. The designation process will be for the new HCBS behavioral health services that will be available to eligible individuals with behavioral health issues through the Health and Recovery Plan (HARP) managed care product lines, beginning in NYC in April 2015. The manual offers helpful information to providers seeking information about contracting, provider qualifications, and service designations.

According to the press release outlining the initial HCBS manual, “all programs wishing to provide HCBS 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. Applications must be submitted via an online portal on the OMH website that will be available beginning in October. Additional guidance will be available shortly.”  All NYC providers' applications must be submitted on or before Dec. 5, 2014. Information and guidance for applicants for the rest of the state will be posted shortly. A separate billing manual with reimbursement rates and billing codes will be available this month.   

The Office of Mental Health (OMH), Office of Alcoholism and Substance Abuse (OASAS) and DOH are asking for stakeholder input on the established service standards, as the 1115 waiver amendment is currently being negotiated with the Centers for Medicaid and Medicare Services (CMS). As with other 1115 waiver amendments, the manual is subject to change based upon the final special terms and conditions approved by CMS. 

All comments on the HCBS manual should be submitted electronically to BHO@omh.ny.gov.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871