UPDATED Notification to Medicaid Managed Care Plans (MMCPs) regarding non-risk minimum payments for Children's Home and Community Based Services (HCBS)
- Notice is also available in Portable Document Format (PDF)
To: Medicaid Managed Care Plans (MMCPs) including Mainstream Medicaid Managed Care
and HIV Special Needs Plans and Children's Waiver Home and Community Based (HCBS) Providers
DATE: Mary 29, 2024
Since October 1, 2019, the date Children's HCBS were included in the Medicaid Managed Care benefit package, Medicaid Managed Care Plans (MMCPs) were required to pay, at minimum, government rates for Children's Waiver Home and Community Based Services (HCBS). Due to the Public Health Emergency, NYS extended the requirement for MMCPs to pay government rates, and most recently extended this requirement for dates of service through June 30, 2024.
Per this notice, MMCPs are required to pay, at minimum, government rates for Children's HCBS with dates of service through September 30, 2024. MMCPs will continue to be reimbursed via non-risk payments for Children's HCBS 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, 2024, to eMedNY via the established rate codes.
Effective October 1, 2024, Children's HCBS are expected to be added to MMCP capitation rates. Further information on adjustments to capitation rates will be provided.
Questions related to this notification can be sent to BH.Transition@health.ny.gov.
