NYAPRS Note: News of the CMS approval of the NYS 1115 Demonstration means the state agencies can proceed with final readiness for behavioral health managed care and HARP specialty plans. This news is significant not only for NYS in beginning this sweeping reform, but also as a signal to other states that have been watching NY closely to determine the best way to proceed with their own behavioral health integration.
CMS Approves NY 1115 Demonstration; HARPs and Behavioral Health Managed Care Proceeds
Dear MRT Listserv Subscriber:
We are pleased to announce a milestone achievement for Medicaid services and its members. The Centers for Medicare and Medicaid Services (CMS) approved the State’s request to amend its 1115 Demonstration Waiver that will enable qualified Managed Care Organizations (MCOs) throughout the state to comprehensively meet the needs of adults with behavioral health needs. This will be achieved by bringing behavioral health services into Mainstream Medicaid Managed Care and establishing Health and Recovery Plans (HARPs), a new type of health plan, operated by MCOs, for eligible adults with Serious Mental Illness (SMI) and Substance Use Disorders (SUD). HARPs will offer an enhanced benefit package of home and community based services (HCBS) to eligible enrollees that will assist individuals in integrating into the community and achieving recovery-oriented life goals.
This initiative is intended to improve clinical and recovery outcomes for individuals with behavioral health issues, reduce the growth in costs through a reduction in unnecessary emergency and inpatient care, and increase network capacity to deliver community-based recovery-oriented services and supports.
For more information and to view the transition timeline, please visit: http://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/index.htm
Thank you.