Session 3
August 15, 2012
AGENDA
• Phase III Health Home Designations and
Next Steps
• Phase I and II Updates
• Enrollment Update
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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
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)
Mental Health Services (Niagara, Wyoming)
Niagara Falls Memorial (Niagara)
Chautauqua County Department of Mental
North Country Children's Clinic, Inc.
Hygiene (Allegany, Cattaraugus , Chautauqua)
(Onondaga, Oswego, Cayuga)
Catholic Charities (Broome)
Additional announcements pending (for
Albany, Otsego, Schoharie, Delaware
and Chenango)
(Jefferson, St. Lawrence)
St. Joseph's Hospital Health Center
United Health Services Hospitals
(Broome)
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• 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
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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
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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.
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• 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
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• 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)
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
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.
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
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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