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Medicaid Redesign Team: Additional Information

August 15, 2013

An announcement from Office of Alcoholism & Substance Abuse Services Commissioner Arlene Gonzalez-Sanchez, Office of Mental Health Acting Commissioner John Tauriello, and Jason Helgerson, Medicaid Director:

The NYS Behavioral Health (BH) Transition Team for Medicaid, comprised of leads from OASAS, OMH, and DOH, is updating the target dates for implementing the transition of BH services.

The Medicaid Redesign Team (MRT) recommended a careful and responsible transformation of the current fee for service system to Medicaid Managed Care for Medicaid enrolled individuals with Substance Use Disorder (SUD) and Mental Health (MH) treatment needs. To implement this recommendation, program design features are being carefully constructed and revised based on feedback from a variety of key sources including BH providers, Medicaid members, MMC Plans, other states with successful track records, and the State's consultants. While no major changes have been made to publicly discussed plans, this critical feedback on details related to program features, baseline data and rate development activities is creating some delays as the team carefully constructs this very important product.

Accordingly, this review and revision will delay final Request for Qualification (RFQ) specifications and HARP and Non-HARP rate development. As previously discussed the RFQ timing is key as the RFQ will qualify Plans as approved to manage the State Plan and new waiver-like BH services on their own or in partnership with a BHO and will establish qualification parameters for Health and Recovery Plans (HARPs) for individuals with higher levels of SUD and MH treatment and support needs.

The new implementation dates are listed below and will afford NYS the opportunity to:

  1. Provide Medicaid Managed Care Plans and Behavioral Health Providers more time to prepare for this major improvement in the way we provide health care to some of our most vulnerable citizens;
  2. continue to work with stakeholders, families and consumers to understand and give us feedback on this major change and to help us better leverage important community based services in the design;
  3. allow for more time to develop key performance measures for this transition and new operation;
  4. allow more time to obtain needed Federal approval for these new services and design and
  5. allow DOH, OASAS, and OMH to continue working on reasonable and efficient plan and service payment rates with the State's actuary.

Revised Implementation Dates:

  • January 1, 2015: Implementation BH Adults in NYC (HARP and Non HARP)
  • July 1, 2015: Implementation BH Adults in Rest of State (HARP and Non HARP)
  • January 1, 2016: Implementation BH Children Statewide

Thank you for your continued support for this critical undertaking. We look forward to eventually leading the nation in providing the best possible care to individuals with behavioral health conditions.