This comes from OMH. Although residential is not in Managed Care yet, many of you operate programs that are in or will be in soon. Even if you are not operating in the MC environment yet, it probably makes sense to watch what is going on with the current roll-out.
This has been a busy time as we complete our first full week of the new managed care services in New York City. The good news is that all the hard work by providers, plans and government partners created a fairly smooth transition for most consumers. That said, everyone has been hard at work dealing with the associated growing pains
In this update we want to share some items of interest to the field. You may have seen some of this in other emails. This update puts it all in one place and reaches those who may not have gotten it previously.
OMH and OASAS have both received requests for a listing of the HARP plans names associated with the Mainstream plan name. The chart below reflects this listing. Also indicated in the chart is a new change for the plan formerly known as Amerigroup.
| Plan Name | HARP Product Name | NYC Designation Status |
| Empire Blue Cross Blue Shield HealthPlus (Formerly HealthPlus Amerigroup) | Empire Blue Cross Blue Shield HealthPlus | HARP |
| HEALTH FIRST PHSP INC | HealthFirst Personal Wellness Plan | HARP |
| Health Insurance Plan of Greater New York (EMBLEM) | EmblemHealth Enhanced Care Plus | HARP |
| METROPLUS PARTNERSHIP CARE SN | MetroPlus Enhanced | HIV/SNP HARP |
| NYS CATHOLIC HEALTH PLAN INC (FIDELIS CARE) | HealthierLife | HARP |
| UNITED HEALTHCARE OF NY INC | UnitedHealthcare Community Plan-Wellness4Me | HARP |
The topic of utilization management is high on many people’s agenda. This week OMH issued a clarification to Mental Health Clinic providers regarding managed care plan provisions for clinics related to 90 day continuity of care provisions and the 30 visits concurrent review. provisions in the managed care plan. A copy of the memo is here.
As consumers move to services under the managed care plans there will be period of time when the old fee-for-service system and the new system are both operating. This creates challenges for billing departments. In an effort to assist them, OMH and OASAS issued billing guidance for the inclusion of behavioral health services in the Medicaid managed care benefit package. A copy of that memo is here for further information.
To help with communication we have set up a new mailbox for your Managed Care questions. To ensure that responses to all questions related to this transition are coordinated, and to help us assemble a list frequently asked questions (FAQs), we are asking that OMH Providers use the OMH Managed Care Question Form for submitting questions, issues and/or concerns to [email protected]
Joseph Swinford
Director, Bureau of Stakeholder Engagement
Office of Managed Care
New York State Office of Mental Health 44 Holland Avenue, 8th Floor Albany, New York 12229
(518) 474-6911 | (518) 473-8255 | [email protected]
www.omh.ny.gov
