New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter E - Medical Care
Article 3 - Policies and Standards Governing Provision of Medical and Dental Care
Part 514 - Provider Verification Of Recipient Eligibility And Orders For Service
Section 514.2 - Introduction
Current through Register Vol. 46, No. 12, March 20, 2024
(a) The department has established an electronic eligibility verification system whereby a provider may determine the eligibility status of any person seeking care, services or supplies under the MA program before furnishing care, services or supplies to such person.
(b) The system was designed to assure that a provider can verify the current MA eligibility of persons seeking medical or dental care, services or supplies and, thus, be assured that legitimate claims submitted to the department for services rendered to eligible recipients will be paid.
(c) If, on the date of service, the provider verifies eligibility in accordance with the verification procedures of this Part, payment will not be denied because the recipient was not MA eligible on the date that the care, services or supplies were furnished.
