§ 365-E — Optional or continued membership in entities offering comprehensive health services plans

New York § 365-E

• Jurisdiction: New York
• Law SOS: Social Services
• Title 11: Medical Assistance For Needy Persons
• Art. 5: Assistance and Care

Text

§ 365-e. Optional or continued membership in entities offering\ncomprehensive health services plans. 1. In accordance with applicable\nfederal requirements and subject to the approval of the commissioner and\nthe director of the budget, a district shall offer to persons eligible\nfor medical assistance the option of membership in any health\nmaintenance organization or other entity which is certified under\narticle forty-four of the public health law or licensed pursuant to\narticle nine-C of the insurance law or otherwise authorized by law, and\nwhich offers comprehensive health services plans to persons residing\nwithin the social services district unless granted a waiver by the\ncommissioner on the grounds that the organization or entity is not\ngeographically accessible so as to provide medical assistance to\neligible recipients who reside within the district or that the per\nrecipient capitation rate is above the expected average per recipient\nfee-for-service cost within the local district or that the health\nmaintenance organization or other entity refuses to enter into a\ncontract with the district.\n 2. Nothwithstanding any inconsistent provision of law, persons who,\nprior to becoming eligible for medical assistance, are enrolled in a\nhealth maintenance organization or other entity offering a comprehensive\nhealth services plan shall be offered the option of continuing that\nenrollment.\n 3. The commissioner shall offer to social services districts such\ntechnical assistance as may be appropriate to assist in the development\nof contracts between the districts and such entities.\n