That said, an important change is coming October 1, 2020; the Look-Back Period will be implemented for home and community based long-term care services (formally referred to as Community Medicaid in NY), such as home health care, adult day care, personal care assistance, and assisted living services. What is Medicaid Managed Care. Medicaid Managed Care (MMC) Billing MMC plans will be providing separate guidance to pharmacies, which will allow billing for service dates on or after the effective date of this guidance. Children’s Health Insurance Program (CHIP) managed care provides for the delivery of CHIP health benefits through contracted arrangements between state CHIP agencies and managed care plans that accept a set per member per month (capitation) payment for these services. Please note NYSDOH publishes the drug formulary information as it is received. Pharmacies participating in MMC should check with the individual health plans to determine how each MMC plan The following resources are provided to assist those who are in need of more information about NYS Medicaid pharmacy benefits and Managed Care plans: Summary of Medicaid Preferred Drug and Managed Care Pharmacy Benefit ; New York State (NYS) Medicaid Preferred Drug List; Kaiser Commission on Medicaid and the Uninsured – A … Choosing a Medicaid Managed Care Plan To find out if you’re eligible for Medicaid, which provides free health insurance coverage to qualifying New Yorkers, visit the NY State of Health, the Official Health Plan Marketplace.

In many counties, once you are eligible for Medicaid, you can join a plan if there is one available and you want to join. If you qualify, the next step is to select a Managed Care Plan. Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Managed Care plans focus on preventive health care and provide enrollees with a medical home for themselves and their families. high needs children into Medicaid managed care plans and provide more services for these children through the Medicaid managed care delivery system. Medicaid Managed Care offers many New Yorkers a chance to choose a Medicaid health plan. Medicaid Managed Care is health insurance from New York State. You have 10 days to choose a health plan. Medicaid Preferred Drug List and Managed Care Plan Information. Medicaid Managed Care Pharmacy Benefit Information Center. The New York State Department of Health (NYSDOH) obtains drug formulary information from Medicaid participating managed care plans on a quarterly basis. Managed Care plans focus on preventive health care and provide enrollees with a medical home for themselves and their families. NYS Managed Care Plans Pharmacy Information; Medicaid Managed Care.