The New York State Medicaid Redesign Team (MRT) recently released its MRT “Boo-Yah!” Report covering projects completed between December 2017 and February 2018.
“The transition of Medicaid Behavioral Health services from a primarily fee-for-service environment to a managed care environment was an initiative of the State’s Medicaid Redesign Team through partnerships with the State Department of Health (DOH), Office of Mental Health (OMH), Office of Alcoholism and Substance Abuse Services (OASAS), the New York City Department of Health and Mental Hygiene, and stakeholders statewide. The initiative was intended to improve clinical and recovery outcomes for individuals with Serious Mental Illness (SMI) and Substance Use Disorder (SUD) by reducing the growth in costs through a reduction in unnecessary emergency and inpatient care while increasing network capacity to deliver community-based recovery-oriented services and supports. As part of this transition, Managed Care Health and Recovery Plans (HARPs) were created to manage care for adults with significant behavioral health needs. These plans facilitate the integration of physical health, mental health, and substance use services for individuals requiring specialized approaches, expertise and protocols which are not consistently found within most managed care organizations (MCO). In addition to the State Plan Medicaid services offered by Mainstream MCOs, qualified HARPs offer access to an enhanced benefit package comprised of Home and Community Based Services (HCBS) designed to provide the individual with a specialized scope of support services not currently covered under the State Plan. Consistent with the workplan, HARP rates were developed and went live in NYC on October 1, 2015 and in the rest of New York State on July 1, 2016.”