In order to refer a member, the member must meet the following eligibility criteria in order to receive Health Home services:
- Have active Medicaid or a Medicaid Managed Care Plan provider. CCMP accepts the following Medicaid Managed Care Plans:
- Affinity
- AlphaCare MLTC
- Amidacare
- CenterLight MLTC
- Centers Plan for Healthy Living MLTC
- ElderServe MLTC
- Emblem Health
- Empire Blue Cross Blue Shield/Health First/Anthem
- Fidelis/NY Catholic and Fidelis MLTC
- Health First
- Independence Care System
- Integra MLTC
- MetroPlus
- Montefiore Diamond Care
- Senior Health MLTC
- Senior Whole Health MLTC
- United Health Plan
- VillageCare Max MLTC
- VNSNY Choice/Select Health
- WellCare
- A Serious Mental Illness and/or HIV/AIDS and/or Two Chronic Medical Conditions
Chronic conditions include but are not limited to:
- Substance abuse disorders
- Diabetes
- Asthma
- Heart Disease
- Overweight (BMI>25)
- Hypertension
Additional Eligibility Qualifying Indicators Include:
- Probable risk for adverse event, e.g., death, disability, inpatient or nursing home admission;
- Lack of or inadequate social/family/housing support;
- Lack of or inadequate connectivity with healthcare system;
- Non-adherence to treatments or medications or difficulty managing medications;
- Recent release from incarceration or psychiatric hospitalization;
- Deficits in activities of daily living such as dressing, eating, etc.;
- Learning or cognition issues.
To find out more about eligibility, ask questions, or find out how to refer a member to one of our Care Management Agencies, please call us!
CCMP Quality and Compliance Manager Nathan Smith: (212) 609-1543 Monday-Friday, 10:00am-6:00pm
CCMP Program Assistant Stephanie Garcia: (212) 609-1838 Monday-Friday, 8:30am-4:30pm
24-hour mailbox: (888) 682-1377