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Magellan Healthcare Behavioral

Behavioral health (BH) brings together care for mental and physical health to help you live . your best life. Magellan Healthcare, Senior Whole Health of New York NHC’s BH services . administrator, connects you with the right care when it’s needed most. They make accessing behavioral health and substance abuse support easy for you through:

Official Site: www.seniorwholehealthny.com

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Provider Handbook Supplement for Senior Whole Health

4—© 2020 Magellan Health, Inc. rev. 11/20 SECTION 1: INTRODUCTION Welcome This Provider Handbook Supplement is designed to give Magellan Healthcare, Inc. (Magellan) network providers specific information on the delivery of behavioral health care services to members in the Senior Whole Health (SWH) plan.

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Senior Whole Health Authorization Guide

Authorization Quick Guide by Level of Care for Senior Whole Health ©2021 Magellan Health, Inc. rev. 03/21 Page 2 diagnosis is primary. Emergency is reimbursed only when the member is not admitted. Crisis stabilization (S9484, S9485) Authorization is required. No Bridge appointments MH Authorization is not required. N/A

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Provider Quick Reference Guide

Senior Whole Health is a health plan available to seniors age 65 and older who have MassHealth Standard. Behavioral Health – Magellan Behavioral Health: 1-800-424-4536 Dental – DentaQuest: 1 844-234-9829 Durable Medical Equipment – Integra Partners: Customer Service: (888) 729-8818

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Magellan Complete Care Segment

Magellan Complete Care Segment Acquisition by Molina Healthcare SWH Provider FAQs . MCC-ALL-PRV-13764-20 Page 1 of 4. We value our relationship with you and will update you as we know more about Molina’s planned acquisition of Senior Whole Health. In the meantime, SWH will continue to provide the quality and compassionate service we

Download: magellan-complete-care-segment-acquisition-by-molina-healthcare-swh-provider-faqs.pdf

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Magellan Health to Acquire Senior Whole Health

"Senior Whole Health is a well-regarded, quality health plan that has served government-sponsored programs since 2004," said Barry M. Smith, chairman and chief executive officer of Magellan Health. "This acquisition will enhance Magellan's geographic reach, membership and expertise in the MLTC market, leveraging Senior Whole Health's intimate

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Leading humanity to healthy

Magellan’s plan, Senior Whole Health, helps more than 13,000 Massachusetts residents live indepen- dently for as long as they can, with the wraparound . services they need to live comfortably. As a testament to this, our member, Gilly, wanted . to live independently his entire life, and Senior Whole

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2020 Provider & Pharmacy Directory

Senior Whole Health Member Services at 1-888-794-7268 (TTY 711) 8 a.m. to 8 p.m., 7 days a week or visit www.seniorwholehealth.com. Changes to our provider/pharmacy network may occur during the benefit year. You will receive notice when necessary. An updated directory is located on our

Download: SWH-06-01-2020-MASS-EN-Hampden-_-Worcester_508c.pdf

From: swh-ma.kaminoprod.magellanhealth.com

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Latimer.

, CIO for Senior Whole Health, reports to Scott Sanders, Chief Information Officer for Magellan Healthcare. Michael Lawley, VP, IT Service Owner from Magellan IT Shared Services, will work closely with Artel Almeida and the infrastructure team to bring the IT services for SWH into the Magellan model.

Download: tjustice-mass-org-announcement-030118.pdf

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How to cope with the stress and trauma

Gary R. Proctor, MD, Senior Behavioral Health Medical Director, Magellan Complete Care of Virginia Anyone who has gone through a traumatic event can develop symptoms of stress disorders such as post-traumatic stress disorder (PTSD). Although the COVID-19 pandemic in general would not meet the criteria for formally causing a stress disorder,

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From: magellanascend.com

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Molina’s public websites in other states. Our website

Magellan Complete Care Segment Acquisition by Molina Healthcare Whole Health MLTC, Senior Whole Health NHC (HMO SNP) • Ohio: Medicaid, Medicare Special Needs Plan (HMO-SNP), Dual Options Medicare-Medicaid Plan (MMP) and Health Insurance Marketplace (Exchange)

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FIDA

(Healthfirst Health Plan, Inc.) Healthfirst CompleteCare (HMO SNP, H3359-034) for participants in the following counties: Bronx, Kings, Nassau, New York, Queens, Richmond, and Westchester Senior Whole Health Senior Whole Healthy of FIDA Plan (Magellan

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Senior Whole Health Frequently Asked Questions

All care for Senior Whole Health members with dates of service prior to December 1, 2006 must be pre-certified by calling Magellan Health Services at: 1 800-991-5640. If treatment continues beyond December 1, 2006 participating and non participating providers must

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This message is being sent on behalf of

Magellan Healthcare, overseeing the medical director and pharmacy teams for Senior Whole Health. o As previously communicated, we have implemented a new UM process, with first-level UM reviews being conducted by our UM nurses. Dr. Menahem Dimant will continue to split his time equally between the Magellan Complete Care of Virginiacontract and

Download: tjustice-swh-org-changes-032218.pdf

From: alphacarecms.magellanhealth.com

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Policy and Standards

Senior Whole Health of New York Senior Whole Health 4D Pharmacy Management Systems Magellan Medicaid Administration Magellan Method (formerly CDMI) Magellan Pharmacy Solutions Magellan Rx Management Magellan Rx Medicare Magellan Rx Pharmacy VRx Pharmacy VRx Policy Statement Magellan Health, its subsidiaries and affiliates, (Magellan) is subject

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Exhibit A 5 Respondent Commitments

- Leverage deep bench of quality subject matter expertise from Senior Whole Health (recent Magellan acquisition) - Preferred provider algorithms - Enhanced use of electronic provider interfaces for data capture and provider incentives - Select and contract with a HEDIS eMeasure vendor

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GreatCall Partners with Senior Whole Health of

Senior Whole Health of Massachusetts, a Magellan Health Company, to provide in-home passive monitoring services for high-risk seniors through their Lively Home monitoring system. Lively Home uses passive sensors to measure daily activities like eating, sleeping and

Download: greatcall-partners-with-senior-whole-health.pdf?sfvrsn=fca75d22_4

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How to cope with the stress and

Gary R. Proctor, MD , Senior Behavioral Health Medical Director , Magellan Complete Care of Virginia . Anyone who has gone through a traumatic event can develop symptoms of stress disorders such as post-traumatic stress disorder (PTSD). Although the COVID -19 pandemic in general would not meet the criteria for formally causing a stress disorder,

Download: covid-19-and-ptsd.pdf

From: magellanhealthcare.com

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Appeals Overview

Magellan Health Services . Attn: Grievance . P.O. Box 84380 . Baton Rouge, LA 70884 Additionally Members may file a grievance Online: Members may log onto Magellan of Louisiana and submit an online grievance through our Magellan Health Services secure messaging system for members. 13 Third Thursday Provider Call (4/16/15): Appeals & Grievances

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Black and White and Grey All Over

suicide. She is the Senior Trainer with Appalachian Consulting Group. She has trained Veterans across the country as peer support specialists on behalf of the Depression Bi-Polar Support Alliance (DBSA). Additionally, she is a Whole Health Action Management trainer …

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(In millions, except per share results) Net revenue

the Health Insurer Fee revenue, and additional investments within our businesses,” said Jonathan N. Rubin, chief financial officer of Magellan Health. “We are also updating guidance to reflect the final amortization of the Senior Whole Health intangible assets as …

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Magellan Complete Care of Florida, Magellan Complete Care of Arizona, Inc., Magellan Complete Care of Louisiana, Inc., Armed Forces Services Corporation, The Management Group, LLC, Senior Whole Health, LLC, Senior Whole Health of New York, Inc., 4-D

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From: oag.ca.gov

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FIDA Demonstration Phase out Plan

Senior Whole Health FIDA Plan (Magellan Health, Inc.) Senior Whole Healthy of New York NHC (HMO SNP, H5992-007) for participants in the following county: Bronx VNSNY Choice FIDA (VNS CHOICE) Complete VNS CHOICE Total (HMO SNP, H5549-003) for participants in the

Download: NYFIDAPhaseOutPlan.pdf

From: cms.gov

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Plan Lists of MLTC, Medicaid Advantage Plus (MAP) & FIDA

21. senior whole health all but si all but si all but si 19. swh whole health fida 22. united healthcare all not offered** 23. village care max all but si all but si 20. villagecaremax full advantage fida plan 24. vns choice all all all 21. vnsny choice fida complete 25. wellcare all all 22. wellcare advocate complete fida -1-

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Exhibit A 5 Summary of Commitments BACK UP DETAIL

Consultative relationship with Shared Health SRC #6, MMA SRC #14; Leverage deep bench of quality subject matter expertise from Senior Whole Health (recent Magellan acquisition) SRC #6, MMA SRC #14 Additional children's care management teams ; SRC #20, SRC #22, Spec SRC # 2 Enhanced enrollee and provider outreach around closing gaps in care

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From: ahca.myflorida.com

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SCOTT MACON HEALTHCARE REVIEW: OCTOBER 2017

10/31/2017 Magellan Healthcare, Inc. / Senior Whole Health, LLC $400.0 NA NA NA NA Operates as a health maintenance organization. 10/9/2017 Paramount Care, Inc. / Health Plan of The Upper Ohio Valley Inc., Workers' Compensation Divisions NA NA NA NA NA Comprises workers' health insurance plans. MEAN (INSURANCE) NA NA MEDIAN (INSURANCE) NA NA

Download: Scott-Macon-Healthcare-Review-Oct-2017.pdf

From: scott-macon.com

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Chief Executive Officer (CEO), Magellan Healthcare

Magellan Health started as a behavioral health company 40 years ago. As a leader in healthcare and pharmacy management, the company provides behavioral health services to more than 25 million o Senior Whole Health, regional long term services and supports and Medicare/Medicaid plan based in Cambridge, MA (largest in company’s history

Download: HHRG-115-IF14-TTF-SrivastavaS-20180411-U2.pdf

From: docs.house.gov

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Data from NYS DOH Monthly Medicaid Managed Care …

22. ALPHACARE (Magellan) 3,414 → Senior Whole Health 23. CenterLight 7,566 42 → Centers Plan 11/2016 24. HHH CHOICES 1,973 0 closed 25. North Shore LIJ 2,604 →Centers Plan 9/2017 Total NYC - MLTC 82,985 136,189 168,341 172,776 rest of state 4,810 39,465 55,227 56,935

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Molina Healthcare to Acquire Magellan Complete Care

Magellan Complete Care is a managed care organization serving members in six states including Arizona and statewide in Virginia . Through its Senior Whole Health branded plans, MCC provides fully integrated plans for Medicaid and Medicare dual beneficiaries in Massachusetts , as well as Managed

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SCOTT MACON HEALTHCARE REVIEW: THIRD QUARTER 2017

Magellan for Senior Whole Health. In the Technol-ogy Services sector, there was a surprising dearth of blockbuster deals in the quarter, but lots of mid-market activity. Japan’s Konica Minolta announced its deal for inviCRO in the medical imaging analy-

Download: Scott-Macon-Healthcare-Review-Q3-1.pdf

From: scott-macon.com

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Magellan Health Receives Regulatory Approvals to Acquire

Magellan now expects closing on or before December 31, 2017. "The receipt of all necessary approvals around this transaction is illustrative of both Magellan's and Senior Whole Health's sound business strategy and execution concerning this acquisition," said Barry M. Smith, chairman and chief executive officer of Magellan Health.

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February 1, 2012: Information Session for Entities that

Senior Whole Health 5. Leanne Berge Network Health 6. Carla Bettano NHP 7. Jo Bower Northeast RLC/Northeast Independent Living 8. Sharon Boyle EHS 9. William Bradshaw Casa Esperanza, Inc. 10. J.P. Burke Sisters of Prov. Health Care 11. Richard Burke FCHP 12. Don Clair Magellan Health 13. Susan Coakley BMC Health Net Plan 14.

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From: mass.gov

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FIDA Demonstration Phase out Plan

Health (NYSDOH) must submit a draft phase-out plan to the Center for Medicare & Medicaid Services (CMS) for approval. 1 While CMS and NYSDOH are already engaged in regular discussions regarding the termination of the FIDA demonstration and transition to Medicaid Advantage Plus (MAP) plans fully

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State of California—Health and Human Services Agency

• Senior Care Action Network (SCAN) • Cal MediConnect health plans (health plan retains existing responsibility) • Major Risk Medical Insurance Program (MRMIP) As of January 1, 2021, Medi-Cal Rx will be responsible for the following pharmacy benefits when billed by a pharmacy on a pharmacy claim: •

Download: APL20-020.pdf

From: dhcs.ca.gov

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CAHP

San Diego to hear from health care experts on a wide array of important issues for health plans. We were joined in our keynote sessions by health care futurists and economists to look into the future of our health care system and to examine how health care impacts our economy and the federal budget.

Download: 2019-Membership-Directory.pdf

From: calhealthplans.org

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Jeanne M. Manzi PharmD, CGP, FASCP

10/12 – 6/14 Senior Whole Health (now Magellan), New York, NY Clinical Pharmacist • Medicare Special Needs Plan servicing members in Massachusetts and New York utilizing the Medical Home Model • Assist with preparation for the NY State FIDA program and readiness review

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NATIONAL CERTIFIED PEER SPECIALIST (NCPS) CERTIFICATION

both public and private whole health practices. As an advanced certification, it is designed to Tom Lane is the senior director of consumer and recovery services for Magellan Healthcare and provides leadership : Before joining Magellan in 2007, Lane worked as vice president of recovery supports and forensic services at a large

Download: NCPS White Paper 11.2.18.pdf

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Magellan in Louisiana – Louisiana Behavioral Health

August 16-17 - Peer support whole health training that will address physical and mental health issues and teach peer s how to take care of themselves. Kathy Coenson asked Board Members if they would be interested in receiving information on the upcoming high level activities and details. Board Members agreed by consensus that they would.

Download: magellan_governance_board_meeting_minutespdf_july_18_2012.pdf

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How to cope with the stress and trauma

health. Review Magellan Healthcare s tip sheet, How to safeguard your mental health while quarantined for helpful information, on MagellanAscend.com. Focus on what you can control and do can help you deal with the unknown. MagellanAscend.com B-T1025 (4/20) ©2020 Magellan He alth, Inc.

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Magellan Health Deploys an Employee Service Center to

Magellan Health Deploys an Employee Service Center to reatly Improve HR Service Delivery —Senior Vice President, Shared Services, Magellan Health In February 2017, the HR team defined three key elements for what the whole person. To accomplish this, the company would:

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Magellan Rx Management

The content is the sole property of Magellan Rx Management and is not published on behalf of any state or state entity. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Figures may be reprinted with the following citation: Magellan Rx Management Medicaid Trend Report™, ©2018.

Download: medicaid-trend-report_2018.pdf

From: www1.magellanrx.com

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2007 HigHligHts: National Recognition, industry impact

Magellan Health Services, Inc. MagnaCare Health Plan Maine Network for Health MAMSI Health Plans Managed Health Network Managed Health Service Senior Whole Health, LLC Sentara Healthcare Siemens Medical Solutions / HDX SIHO Insurance Services Smart Card Alliance Council

Download: CAQH_Highlights_2007.pdf

From: caqh.org

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First Name Last Name Organization Job Title

TMG-Magellan health IRIS Consultant Supervisor; Dana Bzdawka Willow Creek Behavioral Health; Whole Health Clinical Group Vice President Whole Health Clinical Group; IMPACT, Inc Senior Researcher; Penina Manamba A to Z Language Services, LLC; President

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THE INTERSECTION OF HEALTH CARE POLICY & POLITICS

primary advocate within the health care policy community and is the critical link in informing and directing internal stakeholders on current and emerging legislative and regulatory developments. Prior to joining HealthNow, Don was executive director of CMG Health/Magellan Behavioral Health in Buffalo.

Download: nyhpa-confprog-2018.pdf

From: nyhpa.org

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Magellan Behavioral Health of Virginia: Community Forums

Magellan Behavioral Health, Inc Community Forums September, 2013 . 2 Introductions • Glenn A. Stanton, MA, Senior VP, Public Sector Business Development • Evon Bergey, MSW, Vice President Public Sector Operations with a whole-health solution in FL • Partner with health plans, employers, state/local and federal governments and the

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From: magellanofvirginia.com

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Health Plan Does Overlake Medical Does Overlake Medical

Aetna Whole Health PacMed, PolyClinic, Providence/Swedish, Rainier Health Network Magellan Health Services Yes Yes . MHN Behavioral Health Yes Yes Moda Health Plans (First Choice) Yes Yes Senior Health Clinics. Plan is accepted at OMC Urgent & Specialty Care Clinics.

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INSURANCES WE DO NOT ACCEPT

Magellan Complete Care Magna Carta Mail Handlers Benefit Plan Mass Laborers MCA Administrators MASSHEALTH MEDICARE Medical Benefits Office Senior Whole Health Sentry Claims Services Sterling Life Insurance Company Stirling Benefits Inc Travelers TRICARE for Life Tricare North TUFTS HEALTH PLAN Ultra Benefit Inc

Download: SSOINSURANCELIST1.11.17.pdf

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THE STATE OF HEALTHCARE: What’s Next for Healthcare Policy

Senior Whole Health VNA Homecare Options VNS CHOICE Affiliate Members: Beacon Health Options Brighton Health Plan Solutions, LLC CVS Health DentaQuest Eli Lilly Oncology Express Scripts Health Management Associates HealthPlex LIBERTY Dental Plan Magellan Health Services MedImpact ODH, Inc. PerformRx Premier Home Health Care Services Solid

Download: 2017-Conference-Program-Final-1.pdf

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January 2019 Contracted Payers

Aetna Whole Health ACO YY Y Y YACO effective 1/1/17 Magellan Specialty ‐ Behavioral Health Behavioral Health Senior Health Partners Medicare Pace Program NN N/A N N N N/A Select Health (VNS Choice) Medicaid HMO ‐ SNP HIV SNP YY N/A Y Y Y N/A

Download: January-2019-BISLW-ContractedPayers.pdf

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FAQ Senior Whole Health Magellan

How to contact magellan behavioral health senior whole health?

To speak to a nurse 24/7, please call 1-888-794-7268 (TTY 711). To reach Senior Whole Health’s behavioral health partner, Magellan Behavioral Health, please call 1-800-770-3084.

Who is the current owner of magellan complete care?

Magellan Complete Care is now a Molina Healthcare Company. Please contact Molina Healthcare at 888-562-5442​ or the individual health plans listed below for more information. Serving adults, children and those dually eligible for Medicare and Medicaid in Maricopa, Gila and Pinal counties.

Who is eligible for the senior whole health plan?

Senior Whole Health NHC (Nursing Home Certifiable) plan is a Medicare Advantage plan for seniors aged 65 and over who are eligible for both Medicare and Medicaid benefits. Individuals requiring nursing home level of care receive home and community-based support services that allow them to remain comfortably in their own homes.

Who is senior whole health of massachusetts swh?

Senior Whole Health of Massachusetts is committed to maximizing the quality of life, health, security and independence of our members. SWH (HMO SNP) is a Medicare Advantage Special Needs plan for seniors aged 65 and over that combines your Medicare, MassHealth Standard (Medicaid) and Medicare Part D benefits in one convenient plan.

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