How to Refer?

In order to refer a member, the member must meet the following eligibility criteria in order to receive Health Home services:

1. 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
2. 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