For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background
Medicaid in New York:
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services. Information about enrolling in the Medicaid fee-for-service program can be found at: http://www.health.ny.gov/health_care/medicaid/.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
Medicaid Managed Care:
Medicaid Beneficiaries Participating in Managed Care:
Managed care plans participating in the NY Managed Care Program offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office:
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
Managed Care Plans Participating in Managed Care Program:
Aetna Health, Inc.
Affinity Health Plan, Inc.
Amida Care, Inc. Special Needs Plan
Atlantis Health Plan
Plan Website: http://www.atlantishp.com/
Capital District Physician's Health Plan(DPHP)
Empire HealthChoice HMO, Blue Cross Blue Shield
Excellus Health Plan, Blue Cross Blue Shield
GHI HMO, EmblemHealth
Health Insurance Plan of NY, EmblemHealth
Health Net of NY, Inc.
Health Plus, Amerigroup
HealthFirst PHSP, Inc.
HealthNow NY, Inc.
Hudson Health Plan
Independent Health Association, Inc.
MetroPlus Health Plan
MetroPlus Health Plan Special Needs Plan
MVP Health Plan, Inc.
Provider Enrollment: http://www.mvphealthcare.com/provider/index.html
Neighborhood Health Providers NY, Healthfirst
NY State Catholic Health Plans, Fidelis Care
SCHC Total Care
United Healthcare Community Plan of NY
Univera Community Health Universal Healthcare
Visiting Nurse Service of NY Choice Special Needs Plan
WellCare of NY