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 360-10.2 - Scope

Current through Register Vol. 46, No. 39, September 25, 2024

This Subpart describes:

(a) individuals required to enroll in an MMCO;

(b) individuals exempt or excluded from enrollment in an MMCO;

(c) good cause reasons for permitting an enrollee to change or disenroll from an MMCO;

(d) good cause reasons for permitting an enrollee to change primary care providers (PCPs);

(e) the fair hearing rights for managed care enrollees;

(f) marketing/outreach requirements for MMCOs;

(g) MMCO unacceptable practices;

(h) MMCO sanctions and due process.

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