Frequently Asked Questions

NYS Policy Top Question
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Who's included, or carved-in, and who's excluded, or carved out?

Some of the adult clients who are carved-in include those who utilize Personalized Recovery Oriented Services (PROS), mental health / substance use disorder clinics, Assertive Community Treatment (ACT), Home and Community Based Services (HCBS) and opioid treatment programs.

Some of the clients who are carved out include individuals who are 18 - 20 years old and those who participate in Medicaid buy-in, commercial Medicaid or spend down. In addition, dual eligible clients are also carved out.

Source: MCTAC Kick-Off Forum, 1.23.14

On the Adult side, are Medicare or dual eligible recipients eligible for Managed Care?

Medicare recipients and dual eligible clients are currently carved out of the managed care transition.

Source: Managed Care 101 Webinar, 7.21.15