New Idaho Behavioral Health Plan (IBHP) for Providers

The new Idaho Behavioral Health Plan (IBHP) will transform and improve Idaho’s behavioral healthcare system by coordinating behavioral health benefits for Idaho residents. Services will be managed by Magellan Healthcare, Inc. beginning July 1, 2024.

What will be different in the new IBHP?

The new IBHP contract is structured differently than the previous one because a managed care provider, Magellan Healthcare, Inc., will manage behavioral health services for the Divisions of Behavioral Health and Medicaid. Magellan will also manage the provider network for the Department of Juvenile Corrections. Because outpatient behavioral health services will be included in the plan, the Division of Behavioral Health (DBH) will no longer offer outpatient behavioral health services.

July 1, 2024
Providers should submit authorization requests and claims to Magellan for services delivered on or after July 1, 2024. For dates of service prior to July 1, 2024, providers submit using processes used before July 1 , 2024.
Next steps

On July 1, 2024, Magellan will begin managing services for the IBHP.  Visit Magellan's website for important information for the transition.

FAQ

What is changing?

Idaho has awarded a contract to Magellan Healthcare, Inc. who will take over managing behavioral health services and coordinating care for Medicaid and non-Medicaid members.

Who should I contact if I have questions?
  • For questions about an authorization or claim with a service start date before July 1, 2024, contact BPA Health, Optum, or Telligen using the current process. 
  • For questions about authorizations, claims, or provider questions, with a service start date after July 1, 2024, contact Magellan’s provider line at 855-202-0983.
  • Visit Magellan’s frequently asked questions for more FAQ.
When will the changes happen?

Magellan will begin managing the IBHP on July 1, 2024.

How will I know if this change will affect me?

The new IBHP affects providers for all behavioral health services for the Divisions of Behavioral Health and Medicaid. Magellan will also manage the provider network for the Department of Juvenile Corrections.

If I was part of Optum’s network, will I need to join the Magellan network?

Magellan will not “grandfather” providers from other networks.  If you would like to join Magellan's network or have questions, visit Magellan of Idaho's website.

What is an MCO?

A managed care organization (MCO) is an organization that helps you manage your health. Idaho's new MCO for behavioral health is Magellan Healthcare, Inc. Magellan will help you get the services you need by coordinating care and providing behavioral healthcare services through a network of providers.

What behavioral health or non-Medicaid services are covered through the IBHP (or by the MCO )?

The Magellan Provider Handbook describes the services and reimbursement rates that are covered through the IBHP. 

How will TCC and ICC work in the new IBHP?
  • In developing the new Idaho Behavioral Health Plan (IBHP),  the Department identified there is a significant gap in intensive care coordination (ICC) services available for both youth and adults.  
  • To increase capacity, our approach is to transform Targeted Care Coordination (TCC) offered today solely by community providers into a model with Intensive Care Coordination (ICC) as an administrative service provided by Magellan, and Idaho Wraparound Intensive Services (Idaho WInS) and Case Management services offered through IBHP network providers.  
  • This approach is intended to:
    • Standardize member care for intensive care coordination.
      • Improve Service Delivery.
      • Reduce Hospitalizations.
      • Enhance Intensive service needs, identification, and coordination.  
      • Increase engagement with youth in Psychiatric Residential Treatment Facilities and Residential Treatment Centers and their families.
      • Improve Multi-system coordination (Idaho Department of Juvenile Corrections, Children's Developmental Disabilities, Family and Community Services, Medicaid, Idaho Courts).
    • Provide statewide access to ICC for adults and youth and Idaho WInS for youth who meet medical necessity criteria.  
    • Alleviate concerns with CMS for duplication of service.
    • Alleviate concerns with CMS for conflict free case management.  
    • Enhance and expand case management services which can work alongside ICC and Idaho WInS in the new care model.
  • To promote a smooth transition, providers will be able to continue to serve existing members receiving TCC service and bill for TCC services through 12/31/2024. This will provide Magellan 6 months to work with you to transition members to the new ICC services and to begin offering Idaho WInS within the network.  
  • The Department and Magellan will work with providers performing TCC services as we continue to expand the IBHP network to discuss how their role will be changing in the new IBHP as well as other opportunities for them to provide services to Medicaid and other eligible IBHP members.  
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