Recommendation for Community Oriented Recovery and Empowerment (CORE)

Recommendation for Community Oriented Recovery and Empowerment (CORE)

Determination of Medical Necessity
Part 1 - HARP Eligibility

This section may be completed by the care coordinator, Managed Care Organization (MCO),CORE Provider, Services Designated Provider, LPHA, or any other entity with appropriate access to the client record.
Member Name*

First NameLast Name
Member DOB*

MonthDayYear
Date
Member Phone*
Please enter a valid phone number.
HARP Status*

H1: HARP-EnrolledH4: HIV/SNP-Enrolled, meets NYS BH high-needs criteriaH9: meets NYS BH high-needs criteriaOther
Individuals falling into this category are eligible to receive CORE Services when enrolled in a HARP or HIV/SNP. Eligible individuals with an H9 wishing to enroll in a HARP or HIV-SNP may contact NY Medicaid Choice at 1-855-789-4277 for enrollment options.