OMH Managed Care Update – June 2018
NYS Medicaid Managed Care
Health and Recovery Plans (HARPs)
Now Available on the NYS Marketplace
Individuals eligible to enroll in Health and Recovery Plans (HARPs) now have the option to select a HARP on New York State’s Official Health Plan Marketplace, New York State of Health (NYSoH), also known as The Exchange.
Enrolling in a HARP on the NYSoH Online Marketplace:
- Individuals who are eligible for HARP can log on to their NYSoH account and the HARP option will be displayed for plan selection.
- Individuals who are eligible for HARP who are not NYSoH account holders will need to update their consent through a Life Status Change (LSC) before the HARP option will display.
- Individuals who are eligible for HARP and who are the NYSoH account holder will receive a written notice about enrolling in a HARP. Individuals must respond to this notice if they do not wish to enroll in a HARP.
Important Reminder:
All Medicaid recipients must ensure the Medicaid program has your current mailing address!
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Medicaid Managed Care Billing Resources for Behavioral Health Providers
As a reminder to behavioral health providers submitting claims to Medicaid Managed Care Plans, please see the below resources available to you regarding information on billing:
Billing Guidance and Resources on the OMH Managed Care website
- Resources include the Behavioral Health Billing Manual, the Coding Taxonomy that provides rate codes for behavioral health services, outlined provider protections for MCO payment of Government Rates, and additional specified guidance.Billing Webinars and Training Materials
- Understanding the Electronic Billing Claim Cycle
- Mental Health Clinic Billing Part 1, Part 2, and Part 3
- Billing for Adult Behavioral Health (BH) Home and Community Based Services (BH HCBS)
- MCTAC Billing Tool (UB04 Form Interactive)
- Managed Care Billing for OASAS Providers
- General Principles of Revenue Cycle Management and Utilization Management
Children’s System Transformation Update
- NYS has released the updated provider manual for Children and Family Treatment and Support Services (formerly known as Children’s State Plan services). Stakeholder feedback on the Standards of Care (Section VI) can be submitted to [email protected] by July 13, 2018.
- Presentation slides for the Children and Family Treatment and Support Services statewide in-person trainings have been posted to the Managed Care Technical Assistance Center and Department of Health websites.
- NYS has released the Children’s Health and Behavioral Health (BH) Services Medicaid Transformation Billing and Coding Manual. Billing criteria labeled “to be determined” will be updated by the State. Future updates will only supplement current information, not change what is already in place. In addition, NYS will also be releasing a supplemental billing manual that will include guidance on transitional billing procedures.
NYS Behavioral Health Managed Care Contact Information
Office of Mental Health [email protected]
Office of Alcohol and Substance Abuse Services [email protected]
Department of Health [email protected]
Other Contact Information:
Questions regarding HARP eligibility and enrollment: New York Medicaid Choice 1-855-789-4277
New York State of Health 1-855-355-5777
Adult BH HCBS Designation questions or to update status: [email protected]
Children’s System Transition Questions [email protected]
Children’s HBCS/SPA Designation questions: [email protected]