Hot Topics / Priority Issues

Update on NYS Behavioral Health Managed Care Transition

As New York State continues to work with CMS to obtain approval of the 1115 Waiver Amendment to bring Medicaid Behavioral Health services into managed care, the timeline for implementation of the Adult Behavioral Health transition has been updated to reflect the following:

March, 2015 - Anticipated CMS approval

April 1, 2015 – NYC Implementation: HARP Passive Enrollment Letters Distributed (see below for an explanation of passive enrollment process)

July 1, 2015 – NYC Enrollment Begins:  Opt Out Period Ends & Enrollment Broker Sends Final HARP Rosters to MCOs (MCOs Begin to Manage and Pay for BH Services)

October 1, 2015 – ROS Implementation: HARP Passive Enrollment Letters Distributed

January 1, 2016 – ROS Enrollment Begins:  Opt Out Period Ends & Enrollment Broker Sends Final HARP Rosters to MCOs (MCOs Begin to Manage and Pay for BH Services)

 At this point, Children’s Behavioral Health implementation timeline remains unchanged.  

 Explanation of Passive Enrollment Process

 Individuals initially identified by NYS as HARP eligible, who are already enrolled in an MCO with a HARP, will be passively enrolled in that Plan’s HARP. 

1. Individuals identified for passive enrollment will be contacted by the NYS Enrollment Broker. They will be given 30 days to opt out or choose to enroll in another HARP.
2. Once enrolled in a HARP, members will be given additional options to opt out before they are locked into the HARP until the next open enrollment period.
3. Individuals initially identified as HARP eligible who are already enrolled in an MCO without a HARP will not be passively enrolled. They will be notified of their HARP eligibility and referred to the NYS Enrollment Broker to help them decide which Plan is right for them.