Behavioral Health Managed Care
General Information

• Behavioral Health Organizations (BHO) Phase 1 Provider Update
• Hurricane Sandy Guidance Document #3 – Beginning November 13th, and for the duration of the emergency declaration, OMH has authorized BHO care managers to disclose PHI without individual consent for Medicaid beneficiaries to OMH and/or Office of Alcohol and Substance Abuses Services (OASAS) licensed providers who meet certain criteria.
• Parts 580, 582 and 587 - BHO Implementation
  This Notice of Adoption is needed to clarify the expectations of the Office of Mental Health with respect to the BHO implementation and to notify providers of services of their responsibilities as a result of the BHO implementation.
• Selection of Regional BHO
  The New York State Office of Mental Health in conjunction with the New York State Office of Alcoholism and Substance Abuse Services is accepting applications for regional behavioral health organizations (BHO) to provide Medicaid fee-for-service administrative and management services for the purposes of conducting concurrent review of inpatient behavioral health services and coordinating the provision of behavioral health services.

Behavioral Health Benefit and Managed Case - Drafts

• Behavioral Health and Managed Care Agency Agreement for Special Needs Plans and Behavioral Health Organizations in New York City
  The final recommendations of the Medicaid Redesign Team (MRT) Behavioral Health Reform Work Group expressed the intent for full-benefit (behavioral and physical health) Special Needs Plans (SNPs) to be the preferred managed care vehicle in New York City (NYC) for people with significant behavioral health conditions. This outlines the approach to be followed to achieve this goal.
  • Appendix: Strategies to Maximize Special Needs Plan (SNP) Enrollment in New York City (NYC)
    New York State's Department of Health (DOH), OMH, and Office of Alcohol and Substance Abuse Services (OASAS) will work with NYC to develop strategies to promote and maximize SNP enrollment, to assure that the SNP model of integrated specialty care is the dominant approach in NYC. This outlines possible strategies.
• Behavioral Health and Managed Care Agency Agreement for Special Needs Plans and Behavioral Health Organizations Other Than New York City
  In areas outside of NYC, it is expected that a mainstream plan/behavioral health organization (BHO) model will be the predominant approach. The viability of full benefit (behavioral and physical health) Special Needs Plans (SNPs) for regions of the State outside of NYC will be considered. This outlines the approach to be followed.
• Behavioral Health Benefit and Managed Care
  Powerpoint reviewing the recommendations of the Medicaid Redesign Behavioral Health Reform Work Group recommendations and proposed changes to the New York State Behavioral Healthcare sytem.

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.