Children's Home and Community Based Service (HCBS) Authorization Reminder

  • Guidance also available in Portable Document Format (PDF)
January 22, 2025

To: Medicaid Managed Care Plans (MMCPs) and Children's Home and Community Based Service (HCBS) Providers,

This message is being issued to remind MMCPs and Children's HCBS providers of expectations and requirements related to the Children's HCBS authorization process. Effective October 21, 2024, all Children's HCBS Authorization Requests must be in the HCBS Referral and Authorization Portal within the Incident Reporting and Management System (IRAMS). This electronic process was created to promote efficiency and reduce administrative burden of HCBS providers. In an effort to ensure these goals are met, the New York State Department of Health (NYSDOH) is issuing a reminder that MMCPs are required to accept Authorization Requests generated by the HCBS Referral and Authorization Portal. This mechanism was agreed upon between HCBS providers and MMCPs. MMCPs cannot require HCBS providers to duplicate authorization request information into an MMCP Portal, form, or any other format that is separate from authorization requests generated within the NYSDOH IRAMS Referral and Authorization Portal. Requesting that a provider re-type authorization information into an MMCP established portal or form is a duplication of effort that is unnecessary, time-consuming, and contradictory to the goals established in connection to the development of the Referral and Authorization Portal.

By accepting HCBS Referral and Authorization Portal generated Authorization Requests, Plans can assist in significantly streamlining the authorization process and saving time for HCBS providers. MMCPs should review their current processes and make adjustments as necessary.

Thank you for your cooperation in improving our HCBS delivery system. Additional detail about granting MMCPs access to the HCBS Referral and Authorization Portal will be discussed in the upcoming Monthly Meeting Between MMCPs and the State on January 28, 2025.

Questions about this announcement can be sent to BH.Transition@health.ny.gov.