Notification to Medicaid Managed Care Plans (MMCPs) regarding pass through payments (government mandated rates) for Children's Home and Community Based Services (HCBS)

  • Notification also available in Portable Document Format (PDF)

To: Medicaid Managed Care Plans (MMCPs), including Mainstream Medicaid Managed Care and HIV Special Needs Plans
Date: August 26, 2022

New York State (NYS) requires that MMCPs pay government rates (otherwise known as Medicaid fee-for-service rates) for Children's HCBS provided to children/youth enrolled in a MMCP. Effective October 1, 2019, the date HCBS were included in the Medicaid Managed Care benefit package, MMCPs were required to pay, at minimum, government rates for 24 months.

Due to the Public Health Emergency, NYS extended MMCPs to pay government rates without a specific end date.

Per this notice, NYS has extended the deadline required for MMCPs to pay government rates for Children's Home and Community Based Services effective for dates of service through September 30, 2023. Prior to this new date, NYS will be in communication with MMCPs if an additional extension will be considered.

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