Health Homes De-designation Policy #HH0015

  • Policy also available in Portable Document Format (PDF)

Policy Title: Health Home De-designation
Policy number: HH00015
Effective Date: August 1, 2023
Last Revised:

Applicability

This policy pertains to Health Homes Serving Adults and Health Homes Serving Children.

Purpose

The New York State Department of Health (Department) is responsible for designation, redesignation, and de-designation of NYS Medicaid Lead Health Homes (Health Home).

Policy

The Department provides ongoing monitoring and oversight to Health Homes to ensure compliance with federal and state regulations and Health Home Program policies and standards. In the event that the Department finds that a Health Home is not meeting performance requirements and standards, the Department has the authority to de-designate the Health Home.

Process
  1. A Health Home will be moved into de-designation status for any of the following reasons:
    1. As a result of a redesignation audit, the total aggregate score has resulted in de-designation.
    2. The Department determines, with rational basis, the need to issue written notice of immediate termination for gross non-compliance.
  2. Upon issuance of written notice of de-designation pursuant to section 1 above, the Department will schedule and hold a meeting with Health Home leadership to develop a de-designation plan which shall include timelines and step-by-step instructions for wind down of operations leading to the Health Home's closure, including timely transfer of members to other Health Home providers.
References:
  • Health Home Standards and Requirements for Health Homes, Care Management Agencies, and Managed Care Organizations - (PDF)
  • Requirements and Instructions For Using the Notification of Change Form - (PDF)
    See: #2. Corporate Structure Change [closure, merger, separation, governing board])
  • Health Homes Redesignation Policy #HH0014 - (Web) - (PDF) - (previously #HH0012) Updated: July 2023, Effective August 1, 2023