New York Codes, Rules and Regulations
Title 10 - DEPARTMENT OF HEALTH
Chapter II - Administrative Rules and Regulations
Subchapter R - Health Maintenance Organizations
Part 98 - Health Maintenance Organizations
Subpart 98-5
Section 98-5.4 - Network provider type standards
Current through Register Vol. 47, No. 12, March 26, 2025
(a) Pursuant to Public Health Law section 4403(5) (b), a MCO shall ensure that its provider network is adequate to meet the behavioral health needs of enrollees and provide an appropriate choice of providers sufficient to render the behavioral health services covered under its health insurance contracts.
(b) An adequate network of health care providers of behavioral health services shall include residential facilities that provide sub-acute care; assertive community treatment providers; critical time intervention services providers; and mobile crisis intervention services providers, after the commissioner, in consultation with the Superintendent of Financial Services, the commissioner of the Office of Mental Health, and the commissioner of the Office of Addiction Services and Supports, has determined, for each provider type listed in this subdivision, that there is a sufficient number of certified, licensed, or designated health care providers available in this State to meet the network adequacy standards established by Public Health Law 4403(5) (b). Once the commissioner makes this determination, the network adequacy standards shall apply to the provider types listed in this subdivision for contracts issued, renewed, modified, or amended 90 days after the commissioner makes this determination.
