NYAPRS Note: We are pleased to announce that OMH, OASAS, and DOH have released a manual that will serve as a guide to providers in designing HCBS service provision. The manual offers helpful information to providers seeking information about contracting, provider qualifications, and service designations. All stakeholders are welcome to submit comments to the manual, as negotiations with CMS and NYS are ongoing as per service definitions, staffing levels, and implementation guidelines. It is particularly essential that all NYS providers who do not currently bill Medicaid go through this HCBS designation process; not only is it important for the managed care transition, but also to be considered a safety net provider for the DSRIP transformation. See the documents attached, and check the OMH News section to see the documents posted online within the hour.
New York State:
Health and Recovery Plan (HARP)
Home and Community Based Services (HCBS)
Provider Manual
New York State is pleased to release the initial version of the Home and Community Based Services (HCBS) Manual that will be used as a basis to begin the HCBS designation process. The Office of Mental Health (OMH), Office of Alcoholism and Substance Abuse (OASAS) and the Department of Health (DOH) are open to stakeholder input on the established service standards as the 1115 waiver amendment is being negotiated with the Centers for Medicaid and Medicare Services (CMS). This manual is subject to change based upon the final terms and conditions approved by CMS. All comments should be submitted electronically to BHO@omh.ny.gov .
The HCBS manual describes the basic requirements for any entity that is interested in providing HCBS behavioral health services within New York’s public behavioral health system. These entities may include:
- Behavioral health contracted and non-contracted providers, including those that provide rehabilitation, employment, community-based treatment, peer support, and crisis services;
- State entities providing behavioral health services, including mental health and/or substance use disorder services; or other organizations or clinicians that meet criteria;
- Hospitals providing specialized behavioral health services;
- Licensed/ Certified residential, inpatient and organizations providing mental health and/or substance use disorder clinical services; and
- Programs that are currently providing outreach, peer, vocational, or rehabilitative services to people with substance use disorders (SUD) that are funded through Alternatives to Incarceration, Ryan White Federal funding, or funding from Department of Health and Mental Hygiene, NYC Department of Health or the AIDS Institute.
The HCBS Services Manual includes information regarding services that are allowable and reimbursable as approved by CMS. This information, includes service definitions and service requirements reflective of documents that were developed in accordance with Medicaid policies and protocols and submitted for approval. A separate billing manual outlining the reimbursement rates and billing codes will be available in October. Specifically, the HCBS Services Manual outlines the following:
- Services Definitions & Descriptions
- Provider Qualifications
- Eligibility Criteria
- Limitations/Exclusions
- Allowed Modes of Delivery
- Additional Service Criteria
- Practitioner credentials for service provision
- HCBS Services that may be provided together (HCBS clusters)
- Sample attestation forms