On August 15th, the New York State Department of Health (DOH) released for public comment the draft Transition Plan for the Children’s Medicaid System Transformation, which describes the State’s overall approach to implement children’s Health Homes, roll out the six new State Plan Amendment (SPA) services and newly aligned children’s Home and Community Based Services (HCBS). The Transition Plan also carves the following into Medicaid managed care:
- Foster care and other children’s populations; and
- Children’s behavioral health services.
The final Transition Plan, along with the 1115 Children’s MRT Waiver Amendment, must be approved by the Centers for Medicare and Medicaid Services (CMS). DOH will hold a webinar on August 24th from 3pm to 5pm to review the draft Transition Plan in detail and provide the opportunity for stakeholders to ask questions. Registration for the webinar is available here. Comments should be submitted to BH.Transition@health.ny.gov by August 31st. The draft Transition Plan is attached.
The DOH also discussed the Transition Plan at the monthly Children’s Medicaid Redesign Team (MRT) webinar. The webinar provided updates on the designation of SPA and HCBS services and planned requirements and standards for Medicaid Managed Care Organizations (MMCOs) regarding rate mandates, network mandates, and utilization management. The timeline for the Children’s Health and Behavioral Health MMCO Qualification is as follows:
- October 31, 2017 – Submission from Plans due to NYS
- November/December 2017 – Provider/Plan contracting begins
- April 2018 – Plans begin claims testing with providers
- May 2018 – Plan member service staff begin responding to questions related to the expanded children’s benefits and provider network participation
- July 1, 2018 – Plans begin to manage the Children’s Benefit Statewide
All dates are subject to change based on eventual federal approval.