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New York Medicaid Expansion
Medicaid Expansion:
New York is fully participating in the Medicaid Expansion under provisions of the Affordable Care Act (ACA).
 
For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.
 
 
Medicaid in New York:
The NY Department of Health administers the state’s Medicaid program. Information about the state Medicaid program, including beneficiary information, can be found at: http://www.health.ny.gov/health_care/medicaid/.
 
Provider Participation:
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/.
The NY Medicaid website provides information about services covered by fee-for-service payments and payment amounts: 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:
Some Medicaid beneficiaries are enrolled in managed care plans. Basic information about the Managed Care Program can be found at: http://www.health.ny.gov/health_care/managed_care/mamctext.htm.
Some managed care plans cover individual New York counties and independent cities. The Medicaid website has jurisdictional information: http://www.health.ny.gov/health_care/medicaid/.

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.
 
Reporting Problems

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:

http://www.health.ny.gov/health_care/medicaid/

800-541-2831

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.
 
Amerigroup NY
 
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
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