ADHC and AIDS ADHC to be Covered Services Under Managed Care
Effective Aug. 1, 2013, the benefit package for mainstream Medicaid managed care, also known as Medicaid CHOICE/Partnership Plans, will include ADHC and AIDS ADHC.
DOH has established a one-year transition period for the purpose of incorporating ADHC and AIDS ADHC as a covered service under Medicaid Managed Care (MMC). They hope this year will provide for less disruption of registrants and will allow programs to go through the contracting process with MMC plans.
During the first 90 days of the transition period, or until the MMC has conducted a new assessment whichever is later, registrants who are “existing cases” will continue to receive the same number of visits in accordance with their ADHC/AIDS ADHC care plan and the MMC will pay the ADHC or the AIDS ADHC their current FFS rate. Effective with the 91st day, the MMC may modify the treatment plan and reduce the number of visits the registrant has at the program, but the MMC must continue to provide ADHC/AIDS ADHC using the same provider and must pay the program its current FFS rate through the transition year.
To read the entire memo on this policy change, click here. It is important to note that this new information updates the DOH slides originally provided during their June 10 webinar.
Contact: Christine Fitzpatrick, cfitzpatrick@leadingageny.org, 518.867.8383, ext. 130