Changes to Medicaid Managed Care and Behavioral Health

Medicaid is expanding to help people with mental health and substance use disorders (problems with drug and alcohol use) get what they need to live, go to school, work and be part of the community. The changes are happening first in New York City and, later, in the rest of New York State.

Behavioral health is going to be part of Managed Care. What does that mean?

• Managed Care already manages physical health care services for people with Medicaid
• Now, Managed Care will also manage mental health and drug and alcohol use services
• Mental health and drug and alcohol services are sometimes called "behavioral health"

What Do These Changes Mean?

• Behavioral health care, along with physical health care, will be managed by Medicaid insurance plans
• Managed care will pay more attention to behavioral health care to help people with behavioral health needs reach their health and recovery goals
• There will be more behavioral health services in New York�s Medicaid program that people can get in the community.
• Doctors and other service providers will work together to help people meet their own health and wellness goals

Can people keep the clinic or other program they are in now?

• People can keep the providers they have if the providers are in their Medicaid Managed Care Plan�s network
• Managed Care Plans will work with people and their providers to be sure they have the services that are right for them

Who are these changes for?

• People with Medicaid Managed Care only who are age 21 or over

Right now, these changes are not for people who:

• Have both Medicaid and Medicare
• Live in a nursing home
• Have services from the Office for People with Developmental Disabilities (OPWDD) or are in DISCO
• Are in a Managed Long Term Care Plan
• Are under age 21

Latest Information for Recipients

The State hosted public forums in New York City for consumers / recipients in July, August and October. The forums provided information about behavioral health managed care for adults. Materials and a recording of the October 5, 2015 session are available here:

• Forum PowerPoint presentation: Understanding Changes to Medicaid Behavioral Health Care in New York.
• FAQs: Adult Behavioral Health and Managed Care.
• Fact Sheet on Behavioral Health and Medicaid: Changes to Medicaid Managed Care and Behavioral Health

Recording of Consumer Public Forum, Monday October 5, 2015, OASAS Field Office, New York City

Need more information? Go to the Behavioral Health Managed Care webpage.