Notification to Medicaid Managed Care Plans on HCBS FFS Rate Extension
- Notification is also available in Portable Document Format (PDF)
UPDATED Notification to Medicaid Managed Care Plans (MMCPs) regarding non-risk minimum payments for Children's Home and Community Based Services (HCBS)
To: Medicaid Managed Care Plans (MMCPs), including Mainstream Medicaid Managed Care and HIV Special Needs Plans
DATE: September 15, 2022
New York State (NYS) requires that MMCPs pay government rates (otherwise known as Medicaid fee-for-service rates) for Children's HCBS provided to children/youth enrolled in a MMCP. Effective October 1, 2019, the date HCBS were included in the Medicaid Managed Care benefit package, MMCPs were required to pay, at minimum, government rates for 24 months. Due to the Public Health Emergency, NYS extended the requirement for MMCPs to pay government rates without a specific end date.
Per the notification issued on August 26, 2022, NYS has extended the deadline required for MMCPs to pay government rates for Children's Home and Community Based Services effective for dates of service through September 30, 2023. Children's HCBS will continue to be non-risk for MMCPs while this requirement is in effect. MMCPs should continue to submit claims for Children's HCBS with dates of service on or before September 30, 2023 to eMedNY via the established rate codes. Prior to this new date, NYS will be in communication with MMCPs to determine if an additional extension will be considered.
Questions related to this notification can be sent to BH.Transition@health.ny.gov.
