Date Issued: 4/16/2015
This year, Medicaid managed care (MMC) plans will replace regular Medicaid in the coverage of behavioral health services for MMC members aged 21 and older who reside in the five boroughs of New York City. Pending CMS approval, the effective date is July 1, 2015.
EmblemHealth will also offer a new benefit plan associated with the Medicaid Managed Care (MMC) Network called Health and Recovery Plan (HARP). Pending CMS approval, this plan will also begin on July 1, 2015. HARP will offer eligible individuals all of the behavioral health services and physical health services provided by MMC plans, in addition to Home and Community Based Services (HCBS).
HARP is a managed care product for adult Medicaid beneficiaries aged 21 and over who are eligible for mainstream MMCs and meet the criteria for serious mental illness (SMI) and substance use disorder (SUD).
The goal of HARP is to help members prevent chronic health conditions and to recover from serious mental illness and substance use disorders.EmblemHealth Medicaid providers are automatically included in HARP. Providers who do not wish to participate in all of EmblemHealth's Medicaid-based benefit plans, must decline participation in writing. Network opt-out requests may be faxed to Provider Modifications at 1-877-889-9061 or mailed to EmblemHealth: Attention Provider Modifications Team, 55 Water Street, 6th Floor, New York, New York, 10041-8190. In the subject line, you must indicate "Medicaid/HARP Opt Out." Failure to include this subject line may result in inaccurate processing.