Frequently Asked Questions

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What is HARP?

According to the NY Department of Health, "Adults enrolled in Medicaid and 21 years or older with select Serious Mental Illness (SMI) and Substance Use Disorder (SUD) diagnoses having serious behavioral health issues will be eligible to enroll in a new type of health plan, HARP. These specialty lines of business operated by the MCO will be available statewide. Individuals meeting the HARP eligibility criteria who are already enrolled in an HIV Special Needs Plan may remain enrolled in the current plan and receive the enhanced benefits of a HARP. HARPs and SNPs will arrange for access to a benefit package of Home and Community Based Services (HCBS) for members who are determined eligible. HARPs and SNPs will contract with Health Homes, or other State designated entities, to develop a person-centered care plan and provide care management for all services within the care plan, including the HCBS."

Source: OMH UM Training 10.5.15

How do providers determine who has been designated part of a HARP?

Individual HARP eligibility and enrollment are included in ePaces. Information regarding Managed Care Plans that participate in HARP is available at the MCTAC Plan Matrix.

Source: OMH UM Training 10.5.15

How many individuals are enrolled in a HARP?

New York State has identified approximately 120,000 individuals throughout NYS.

Source: 2017

Who will determine if an adult is HARP eligible?

New York State determines who is HARP eligible. Individuals are eligible if they meet target risk criteria/risk factors or are identified by the service system or a service provider.

Target Criteria:
-Eligible for mainstream enrollment and Medicaid enrolled,
-21 and older,
-Serious Mental Illness/Substance Use Disorder diagnosis,
-Not dually eligible for Medicare,
-Not participating in OPWDD program

Source: Managed Care 101 Webinar 7.21.15

Are adults in HIV SNPs included in HARPS?

Individuals in HIV SNPs are eligible for all services associated with HARP/HCBS under same rules as HARP eligible individuals.

Source: Managed Care 101 Webinar 7.21.15

Should Health Homes assess only HARP-enrolled individuals, or are we expected to assess all HARP-eligible individuals for Behavioral Health Home and Community Based Services (BH HCBS) eligibility?

Prior to conducting the adult BH HCBS assessments, Health Home Care Managers MUST verify HARP enrollment. See guidance at: http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/docs/community_mental_

health_assessments_billing_guidance.pdf

Source: State Released HCBS Q&A March 2016