New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter B - Public Assistance
Article 2 - Determination of Eligibility-Categorical
Part 360 - MEDICAL ASSISTANCE
Subpart 360-10 - MEDICAID MANAGED CARE PROGRAMS
Section 360-10.1 - Introduction
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Most Medicaid recipients are required and some recipients may elect to receive health services from a Medicaid managed care organization (MMCO). Individuals eligible for Family Health Plus, except for those who participate in the Family Health Plus Premium Assistance Program, are required to receive health care services from a MMCO.
(b) An MMCO must provide or arrange for the provision of all services set forth in its benefit package to its enrollees. The commissioner shall assure that Medicaid recipients in managed care have access to all services to which they are entitled under the Medicaid program, including services, if any, that are not included in their MMCO's benefit package and provided through the Medicaid Fee for Service Program. Family Health Plus enrollees are eligible for the services specified in section 369-ee of the Social Services Law.