CCO Guidlines

New York State is transitioning Medicaid Service Coordination providers to a conflict free model

  • OPWDD has determined, per federal request, that the current structure of MSC service provision needs to be changed. OPWDD will shortly be releasing a request for applications to designate large regional CCOs that are not service providers to assume these functions. OPWDD has indicated that there will be a period of transition when the CCOs will contract with current MSC providers, followed by the development of workforce transition plans.
  • Current MSC providers and others who care for persons with IDD should consider options now to support stability for individuals and providers.
  • Tri-County Care plans to become a CCO and seeks to partner with eligible MSC providers in this transition
  • Tri-County Care will use itsstrong experience andreputation in New York to helpyour organization during thetransition:
  • Tri-County Care will use itsstrong experience andreputation in New York to helpyour organization during thetransition:
  • Providers gain continuity with smooth transition across payrolls;
  • Individuals will be shielded from disruption to services;
  • Provider Partners will be included in operational decision-making; and
  • Leverage Tri-County Care facilities, best practices and infrastructure.
  • Agencies must remember that they will retain access to their own individuals by partnering with Tri-County Care. Nobody is trying to disrupt individuals’ relationships with their current MSCs or care givers.

NEXT STEP: Execute the Letter of Intent with Tri-County Care

  • MSC providers will be required to work with a single CCO. To participate with Tri-County Care, your agency must sign a Letter of Intent committing for 180 days to contract only with Tri- County Care. Once NYS clarifies timelines for contracting, Tri-County Care and your agency may extend the exclusivity agreement. When detailed contracting guidance is available, Tri-County Care will engage your organization in negotiations with favorable terms.

Your MSC organization can take steps forward to partner with a trusted agency today

  • Tri-County Care will help you and your organization navigate the transition to managed care as a partner with a CCO, minimizing the disruption to individuals and employees while improving outcomes of care.
  • OPWDD will require MSC service coordination providers to first transition to providing CFCM services, and later move service coordination staffto the payroll of the CCO. Tri-County Care willcontract with your organization and help with thetransition from being an MSC to a CFCM servicesprovider and ultimately a CCO partner.
  • Partnering with Tri-County Care now – rather than waiting for OPWDD to assign your organization to a CCO – means your individuals served and staff keep more autonomy in areas of care planning, family engagement, service referrals and treatment settings.

Add Letter of Intent PDF

For more question Click FAQ
Layer 1