New York Laws
Title 3 - Program for Elderly Pharmaceutical Insurance Coverage
246 - Regulations.

§ 246. Regulations. Program regulations shall:

1. Provide for a process of determining and redetermining eligibility
for participation in this program including provisions for submission of
proof of income, age, and residency and information on existing complete
or partial coverage of prescription drug expenses under a third party
assistance or insurance plan;

2. Provide for a fair hearing process pursuant to an agreement with
the department of health for individuals and participating provider
pharmacies to appeal determinations or actions of the contractors;

3. Establish procedures for the state to recover the value of benefits
or payments made under this title, if any, that were based on
applications or claims submitted in violation of any provision of this
title; and

4. Establish procedures to ensure that all information obtained on
persons pursuant to paragraph (a) of subdivision two of section two
hundred forty-three of this title shall remain confidential and shall
not be disclosed to persons or agencies other than those entitled to
such information because such disclosure is necessary for the proper
administration of the program established pursuant to this title.