Behavioral Health Managed Care
NYS is moving Medicaid behavioral health services into Managed Care. Behavioral Health Managed Care will integrate all behavioral health (BH) and physical heath (PH) services under the management of Mainstream Medicaid Managed Care Organizations (MCOs) and Health and Recovery Plans (HARP).
In 2011, Governor Cuomo called for "a fundamental restructuring of (the) Medicaid program to achieve measurable improvement in health outcomes, sustainable cost control, and a more efficient administrative structure."
Managed Care Updates: Weekly News on New York's Behavioral Health Managed Care Implementation Process
To meet these goals for people with mental health and/or substance use conditions, the Governor appointed a Medicaid Redesign Team (MRT) Behavioral Health Workgroup. The Workgroup developed these principles and recommendations for moving behavioral health services into managed care:
- Coordinated Care
- Integration of physical and behavioral health services
- Recovery oriented services
- Patient/consumer choice
- Protection of continuity of care
- Ensure adequate and comprehensive networks
- Tying payment to outcomes
- Track physical and behavioral health spending separately (firewall)
- Reinvest savings to improve services for behavioral health populations
- Address the unique needs of children, families and older adults
The NYS Office of Mental Health (OMH) is working closely with the Department of Health (DOH) and Office of Alcoholism and Substance Abuse Services (OASAS) to make sure that the MRTís recommendations and principles guide the change to managed care.
The change to managed care is taking place in two phases. The first phase, BHO Implementation (BHO Phase 1), ended December 31, 2013. Phase 2 will begin in NYC on October 1, 2015, and in the rest of New York beginning July 2016.
Please contact OMH Managed Care with any questions, comments or problems you may be experiencing with this site. If you would like to file a complaint about behavioral health managed care, please visit the Information on Filing a Complaint Page. Providers, if you have any questions about the managed care implementation, please complete and send a question form.