On June 22nd, the New York State Department of Health (DOH) hosted its quarterly Children’s Medicaid Redesign Team (MRT) webinar outlining key updates regarding the Children’s 1115 MRT Waiver submission. In particular, the webinar discussed important modifications in the most recent submission, including:
- Once approved, the Children’s 1115 MRT Waiver will be implemented Statewide;
- The Waiver avoids bifurcating the transition of Care at Home/medically fragile children to Managed Care by including OPWDD CAH and DOH CAH waivers; and
- Residential Rehabilitation Services for Youth (RRSYs) will remain carved out of Managed Care and will transition at a later date.
The timeline for the Waiver submission is as follows:
- May 9, 2017 – Waiver submitted to CMS.
- January 1, 2018 – Effective date of Waiver amendment; authority of six 1915(c) Children’s Waiver transitions to 1115 Waiver authority.
- January 1, 2018 to July 1, 2018 – Preparatory activities for aligned service delivery and transition of care coordination for children/families from 1915(c) Children’s Waivers to Health Home.
- July 1, 2018 to December 31, 2018 – Complete alignment of Children’s HCBS 1915(c) under 1115 (Level of Care Population).
- July 1, 2018 – Children’s Behavioral Health Benefits Transition to Managed Care and Exemption from Enrollment in Managed Care will be Removed for Children in the Six 1915(c) Waivers
- January 1, 2019 – Foster care population moves to managed care and expansion of Children’s HCBS for Community Eligible and Family of One Level of Need Population.
In addition, the webinar discussed the application to become a designated Children’s SPA or HCBS provider, which has been modified. The modified applications will be released shortly and instructions for accessing the application will be available here. Applications must be submitted no later than July 31st for initial implementation. After that, applications will be accepted on a rolling basis. Providers who submitted applications prior to June 14th will receive an email from DOH requesting additional information. Formal designations are expected to be announced in October.
The NYS DOH’s full webinar presentation can be found here.