State Seeking Comments on I/DD Transition to Managed Care
The Department of Health (DOH) and the Office for People With Developmental Disabilities (OPWDD) are seeking comments on a draft version of the New York State Medicaid Managed Care Organization I/DD System Transformation Requirements and Standards to Serve Individuals with Intellectual and/or Developmental Disabilities in Specialized I/DD Plans – Provider Led (SIP-PL). SIP-PLs will be specialized managed care plans led by provider organizations in the OPWDD system with a history of serving New Yorkers with intellectual and/or developmental disabilities (I/DD). Once the comments are reviewed and the transformation plan is finalized, DOH and OPWDD will solicit applications to qualify specialized Managed Care Organizations (MCOs) to manage the delivery of cross-system services, including OPWDD-specialized services and other Medicaid-funded acute health care services for individuals with I/DD.
The intent is to expand the availability of services for the I/DD population within Medicaid Managed Care to fundamentally restructure and transform the health care delivery system for individuals with I/DD enrolled in Medicaid.
Among its many provisions, the draft transition plan establishes special requirements for “Early Adopter” plans for developing and operating a SIP-PL. The term “Early Adopter” refers to I/DD-led organizations that are approved to operate an Article 44 Medicaid Managed Care Plan. Organizations that have not obtained Article 44 licensure and apply to become a SIP-PL will need to complete a SIP-PL application, which will include elements from the Medicaid Managed Care application.
LeadingAge NY contact: Darius Kirstein, firstname.lastname@example.org, 518-867-8841