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Health Home Implementation Update

Health Home Implementation Update. Session 3 August 15, 2012. Health Home Implementation . AGENDA Phase III Health Home Designations and Next Steps Phase I and II Updates Enrollment Update. Phase III Designated Health Homes. Central Thomas R. Mitchell, MD, PC (Chemung)

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Health Home Implementation Update

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  1. Health Home Implementation Update Session 3 August 15, 2012

  2. Health Home Implementation • AGENDA • Phase III Health Home Designations and Next Steps • Phase I and II Updates • Enrollment Update

  3. Phase III Designated Health Homes Central Thomas R. Mitchell, MD, PC (Chemung) Onondaga Case Management Services (Cortland, Madison, Onondaga, Oswego, Cayuga, Tompkins, Tioga) Upstate Cerebral Palsy, Inc. (Herkimer, Lewis, Madison, Oneida, Cayuga) Huther Doyle Memorial Institute, Inc. (Livingston, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates, Genesee, Orleans) North Country Children's Clinic, Inc. (Jefferson, St. Lawrence) St. Joseph's Hospital Health Center (Onondaga, Oswego, Cayuga) Catholic Charities (Broome) United Health Services Hospitals (Broome) Northern Hudson River HealthCare (Columbia, Greene) St. Mary's Healthcare (Fulton, Montgomery) Samaritan Hospital (Rensselaer) Adirondack Health Institute (Saratoga) Glens Falls Hospital (Saratoga) VNS of Schenectady and Saratoga (Saratoga) Western Mental Health Services (Niagara, Wyoming) Niagara Falls Memorial (Niagara) Chautauqua County Department of Mental Hygiene (Allegany, Cattaraugus , Chautauqua) Additional announcements pending (for Albany, Otsego, Schoharie, Delaware and Chenango)

  4. Phase III-Next Steps • Phase III Health Homes will receive a designation letter, which must be signed and returned to DOH to document agreement to comply with Health Home requirements • For some Health Homes contingencies will be identified in the letter which must be addressed

  5. Phase III-Next Steps • Enclosed with the contingency letter is a checklist of steps the Phase III Health Homes must take: • Update Health Home contact information-contacts will be posted based on what was submitted in the application (request for updates has been emailed) • Update Partner lists to ensure accurate loyalty analysis • Clone links are being emailed to allow access to partner tables in the original application • All fields in the partner tables must be in place in order to upload correctly. Only the person who will be updating the list should click on the link that is sent

  6. Phase III-Next Steps • Other steps include: • Executing a DEAA with DOH, and with any network partners, to allow sharing of unconsented information (forms to execute DEAAs will be sent) • Ensure access to an active Health Commerce System (HCS) account to share member lists • Obtain or update Medicaid provider enrollment as needed. A request for billing information , e.g., NPI, MMIS, name address, will be sent.

  7. Phases I and II Updates • Updated Phase I and II Network Partner lists and lists of Managed Care Plan contacts are posted on the Health Home website. Please review lists for accuracy: • http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/prov_lead_designated_health_homes.htm • http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/managed_care_plan_contact_list.htm • Loyalty analysis is being done to refine Phase I and Phase II Health Home assignments

  8. Phases I and II Updates • DOH is responding to questions from CMS on Phase II and Phase III State Plan Amendments (SPAs) Enrollment of new members in Phases II and III cannot proceed until SPAs are approved • Health Homes and Managed Care Plans are executing contracts • Working out implementation issues (policy and operational)

  9. Health Home Enrollment Update • Health Homes must be enrolled as a Medicaid provider and have a NPI number, a MMIS provider I.D. and a category of service (COS) 0265 in order to bill for case management services • See the eMEDNY website for enrollment information: (https:www.emedny.org/info/providerenrollment/index.aspx) • Phase III designated Health Homes should not submit Medicaid provider enrollment applications until their designation letters have been received. At that time, DOH will provide guidance on provider enrollment instructions.

  10. Health Home Enrollment Updates • The Medicaid program updated the provider enrollment application forms on August 10th. Current provider enrollment application forms will be accepted through August 17th. • If your application cannot be received by that date, you must complete the new provider enrollment forms which are available on the eMedNY website: https:www.emedny.org/info/providerenrollment/index.aspx • Send the completed provider enrollment application to CSC (Computer Science Corporation, 1 800-343-9000)

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