60-Day Notice to the MLTC Plans for BH Carve-in

• Notice is also available in Portable Document Format (PDF)

October 31, 2022

Dear Medicaid Advantage Plus (MAP) Health Plan Administrator:

Pursuant to Section 2.14 of the Medicaid Advantage Plus (MAP) Model Contract, Modification of the Benefit Package Services, the Department of Health (Department) must provide Medicaid Managed Care Plans (MMC Plans) at least 60 days advance notice of modifications to the benefit package. This notification applies to MAP Plans.

Effective January 1, 2023, behavioral health services will be carved into MAP Plans. Additional information, including a list of behavioral health services MAP plans are required to provide, can be found in the 2023 MAP Handbook Template. This change in benefit will streamline services for MAP enrollees.

MAP Plans will be responsible for providing and coordinating behavioral health services and will be required to enhance networks and update policies, procedures, and plan benefit materials accordingly. MAP Plans must provide behavioral health benefit package services to all members enrolled in their plan, who meet the criteria for such services.

MAP Plans will be required to complete readiness activities for the behavioral health transition prior to January 1, 2023. Plans with a pending MAP application will be required to complete readiness activities prior to the approval of MAP contracting.

If you have any questions, please send them via e-mail to: BHO@omh.ny.gov, and/or OASAS.SM.BehavioralHealthMMC@oasas.ny.gov and copy the MLTC plan manager.

Sincerely,

Jonathan Bick Director
Division of Health Plan Contracting and Oversight
Office of Health Insurance Programs