State Seeking Comments on I/DD Transition to Managed Care

The Department of Health (DOH) and the Office for People With Developmental Disabilities (OPWDD) are seeking comments on a draft version of the New York State Medicaid Managed Care Organization I/DD System Transformation Requirements and Standards to Serve Individuals with Intellectual and/or Developmental Disabilities in Specialized I/DD Plans – Provider Led (SIP-PL). SIP-PLs will be specialized managed care plans led by provider organizations in the OPWDD system with a history of serving New Yorkers with intellectual and/or developmental disabilities (I/DD). Once the comments are reviewed and the transformation plan is finalized, DOH and OPWDD will solicit applications to qualify specialized Managed Care Organizations (MCOs) to manage the delivery of cross-system services, including OPWDD-specialized services and other Medicaid-funded acute health care services for individuals with I/DD.

The intent is to expand the availability of services for the I/DD population within Medicaid Managed Care to fundamentally restructure and transform the health care delivery system for individuals with I/DD enrolled in Medicaid.

Among its many provisions, the draft transition plan establishes special requirements for “Early Adopter” plans for developing and operating a SIP-PL. The term “Early Adopter” refers to I/DD-led organizations that are approved to operate an Article 44 Medicaid Managed Care Plan. Organizations that have not obtained Article 44 licensure and apply to become a SIP-PL will need to complete a SIP-PL application, which will include elements from the Medicaid Managed Care application.

The draft document is posted here. Comments are due on or before Oct. 3, 2018 and should be submitted to peoplefirstwaiver@opwdd.ny.gov.

LeadingAge NY contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841