Phase 1 and Phase 2 Health Home Serving Children

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Implementation Schedule for MAPP Health Home Tracking System Phase 1 and Phase 2 and Enrolling Children in Health Homes

Dear Health Home Community,

To ensure that providers have an appropriate amount of time to adjust provider systems and procedures for the implementation of MAPP and other related Health Home program requirements (e.g., the implementation of “High, Medium and Low”, the elimination of direct billing, the prioritized enrollment of HARP and Adult Home members); and to address system functionality needed to adequately support Phase 1 MAPP requirements, Phase 1 of the MAPP HHTS will be implemented in March 2016.

In addition, based upon an assessment and review of the progress made by Health Homes contingently designated to serve children to finalize governance structures, address contingencies and meet other readiness and Health Home administrative requirements; requests from providers for more time to meet these requirements; and the impact of the March 2016 Phase 1 Go Live date on developing and implementing Phase 2 of MAPP for children, the enrollment of children in Health Homes and the implementation of Phase 2 MAPP HHTS will now begin in September 2016.

The new MAPP implementation schedule will result in the following changes:

  • Former OMH and COBRA Targeted Case Management (TCM) and OASAS Managed Addiction Treatment Services (MATS) providers may continue to bill Medicaid directly for Health Home services using legacy rates for service dates up to and including August 2016.
  • The HML monthly assessment/questionnaire will be available in MAPP in March 2016 and will be required to be completed for service dates beginning April 2016.
  • The transition to HARP/non-HARP HML payment for Health Home services will begin with September 2016 service dates.
  • Health Home billing readiness attestations required to be submitted by existing Health Homes (including those designated to serve children) certifying they have procedures in place, and have tested their ability to bill Plans for Health Home services and pass Health Home payments to downstream care managers will be due on May 1, 2016.
  • Information about MAPP training for children’s Health Homes will be made available after Phase 1 is launched. The Department will continue to work with contingently designated Health Homes on readiness activities, including obtaining network provider lists and other information necessary to operationalize MAPP modifications for children.

The Department anticipates that the Health Home performance dashboards will be made available to MAPP users prior to the March 2016 MAPP Go Live date (possibly as early as December 2015). Additional information on how to access the Health Home performance dashboards will be provided to you as soon as soon as MAPP is configured to display the dashboards.

Phase 1 of the MAPP Health Home Tracking System (HHTS) will provide users with the following functionality that is not in the current Health Home Tracking System:

  • Care Management Agencies will have access to the MAPP HHTS.
  • Actions within MAPP can be performed individually or in bulk through online screen entry or through file transfer.
  • The creation, acceptance and rejection of assignments made from the Managed Care Plan to the Health Home to the Care Management Agency will be tracked in MAPP HHTS.
  • New concept of “accepting” of assignments, transfers, and referrals by all users and of Health Home “accepting” assignment, outreach, and enrollment submitted by Care Management Agencies
  • Allow seamless “warm” transfer of enrolled Health Home members between health homes
  • Uses status types and new end date reason codes for members in Assignment, Outreach, and Enrollment to better track members in outreach hiatus, incarcerated and lapsed Medicaid eligibility

Phase 2 of the MAPP Health Home Tracking System (HHTS) will add functionality to MAPP to support the design of the Health Home model for children, including:

  • CANS-NY Assessment tool will be integrated into MAPP
  • Billing, rate information and CANS-NY algorithms (High, Medium, Low)
  • Referral Portal for Children (under 21)
    • Community Referral (by LGU/SPOA and LDSS, and eventually others) for Assignment
    • Assignment and Enrollment by Health Homes, Plans and Care Managers
  • Consent Management
    • Consent to Refer
    • Consent to Enroll
    • Consent to Share Information (Protected Services)

Additional information on access to the MAPP HHTS test environment for Phase 1 will be provided next month. To prepare for file testing in the test environment, OR TO BETTER UNDERSTAND THE MAPP HHTS, please read through the MAPP HHTS Specifications Document that is posted to the MAPP section of the Health Home website (link below).

MAPP HHTS Specifications Document

If you have any questions about the individuals from your organization that are registered as MAPP users, please contact your organization’s single point (SPOC) of contact, which is available at the link below. If your organization’s SPOC has any questions about your organization’s MAPP HHTS users, have your SPOC contact us by submit an email to the Health Home email web form using the link below under the “Medicaid Analytics Performance Portal” subject heading.

Link to SPOC list

Health Home email webform link

The Department will continue to provide regular updates on our progress and thanks you for your continued patience, partnership, feedback and hard work.

Thank You,
NYSDOH Health Home Program