CCO

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

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