OMH – Monthly Children’s Health and Behavioral Health Managed Care Plan Provider Roundtable

The Children’s Roundtable meeting took place on August 28, 2019. Agencies providing any of the new Children and Family Treatment and Support Services or Children’s Home and Community Based Services are welcome to attend these monthly meetings.
  • This meetings largely focus on implementation discussions between plans and providers.
  • Service Providers are highly encouraged to join these meetings in-person at respective locations.
  • Managed Care Organizations are required to send representation in-person for plan-provider conversations.

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Peer Advocate Service Rate Enhancement Guidance Effective 9/1/2019

OASAS in an effort to support OASAS Certified Programs in the provision of effective, accessible Addictions Treatment has been working with the Center for Medicare and Medicaid Services (CMS) to increase reimbursement for certain elements of the treatment deemed vital in the treatment process. On March 25, 2019 The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 160004. The SPA allows for a 50% rate enhancement for Part 822 Outpatient Program Peer Advocate Services.

 

Crisis Intervention Benefit: Mobile Crisis Component Benefit and Billing Guidance

A new Crisis Intervention benefit became effective in Medicaid Managed Care in New York City in 2015, and for the remainder of New York State (State) in 2016. The Crisis Intervention benefit is comprised of several service components that are available to children, youth, and adults. The benefit components include Mobile Crisis services as well as residential and stabilization services.

Community Health Choices Fact Sheet: Service Coordination

SERVICE COORDINATION includes activities to identify, coordinate, and assist participants in obtaining access to needed health services and in-home supports, as well as social and housing services needed to help participants live in their communities. Under CHC, a service coordinator is a managed care organization’s (CHC-MCO) designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan (PCSP), and service coordination.

NOW AVAILABLE: AMENDMENTS TO THE CONSOLIDATED, COMMUNITY LIVING, AND P/FDS WAIVERS SUBMITTED TO CMS

The Office of Developmental Programs (ODP) is pleased to announce that the amendments for the Consolidated, Community Living and P/FDS waivers were submitted to CMS on July 19, 2019. The submitted waivers include modifications that were made as a result of the comments received by 17 individuals, families, agencies, and organizations. Each full waiver application, as well as a side-by-side of substantive changes made as a result of public comment, is available online here.

ODP 19-107: Now Available Version 3 of the Community Participation Support Question and Answer Document

Q1. Will the provision of “no provider owned, leased, or operated facilities” be removed from the definition of a community setting? No, the definition of community locations remains, “Locations must be non-disability specific and meet all federal standards for home and community-based settings. When provided in community locations, this service cannot take place in licensed facilities, or any type of facility owned, leased or operated by a provider of other ODP services. Services are provided in a variety of integrated community locations that offer opportunities for the participant to achieve his or her personally identified goals for developing employment skills, community inclusion, involvement, exploration, and for developing and sustaining a network of positive natural supports. A maximum of 3 participants can be served simultaneously by any one provider at a community location at any one time.”

CMS Advances MyHealthEData with New Pilot to Support Clinicians

Today, at the White House Blue Button Developers Conference (BBDC), the Centers for Medicare & Medicaid Services (CMS) announced changes that further protect and strengthen Medicare by unleashing the power of data and placing it firmly where it belongs, in the hands of patients and the clinicians who treat them.

 

Governor Cuomo Announces $187 Million in Funding to Strengthen and Preserve Access to High-Quality Health Care

Governor Andrew M. Cuomo today announced $187 million in funding to support 25 statewide projects that will protect and transform New York State’s health care system. This funding from the Statewide Health Care Facility Transformation Program will improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout the State.

CMS Drug Pricing Transparency Fact Sheet

In May 2018, President Trump and Secretary Azar introduced the American Patients First blueprint – PDF to bring down prescription drug prices. Less than a year later, we are publishing the first final rule to implement the vision laid out in the blueprint.

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Peer Support Services in Outpatient Clinical Settings 

The Office of Alcoholism and Substance Abuse Services (OASAS) recognizes Substance Use Disorder (SUD) as a chronic condition best managed by a broad continuum of services. As with other chronic conditions, where reoccurrence of symptoms is possible, the ability to integrate non-clinical support is essential to comprehensive care planning. OASAS supports efforts to further expand available clinical and non-clinical support services for individuals and families living with SUD, including the development of a Recovery Oriented System of Care (ROSC).

 

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