New York Laws
Title 11 - Medical Assistance for Needy Persons
364-JJ - Special Advisory Review Panel on Medicaid Managed Care.

(b) The panel shall:
(i) determine whether there is sufficient managed care provider
participation in the Medicaid managed care program;
(ii) determine whether managed care providers meet proper enrollment
targets that permit as many Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;
(iii) review the phase-in schedule for enrollment, of managed care
providers under both the voluntary and mandatory programs;
(iv) assess the impact of managed care provider marketing and
enrollment strategies, and the public education campaign conducted in
New York city, on enrollees participation in Medicaid managed care
plans;
(v) evaluate the adequacy of managed care provider capacity by
reviewing established capacity measurements and monitoring actual access
to plan practitioners;
(vi) examine the cost implications of populations excluded and
exempted from Medicaid managed care;
(vii) evaluate the adequacy and appropriateness of program materials;
(viii) examine trends in service denials;
(ix) assess the access to care for people with disabilities;
(x) in accordance with the recommendations of the joint advisory
council established pursuant to section 13.40 of the mental hygiene law,
advise the commissioners of health and developmental disabilities with
respect to the oversight of DISCOs and of health maintenance
organizations and managed long term care plans providing services
authorized, funded, approved or certified by the office for people with
developmental disabilities, and review all managed care options provided
to persons with developmental disabilities, including: the adequacy of
support for habilitation services; the record of compliance with
requirements for person-centered planning, person-centered services and
community integration; the adequacy of rates paid to providers in
accordance with the provisions of paragraph 1 of subdivision four of
section forty-four hundred three of the public health law, paragraph
(a-2) of subdivision eight of section forty-four hundred three of the
public health law or paragraph (a-2) of subdivision twelve of section
forty-four hundred three-f of the public health law; and the quality of

life, health, safety and community integration of persons with
developmental disabilities enrolled in managed care; and
(xi) examine other issues as it deems appropriate.
(c) Commencing January first, nineteen hundred ninety-seven and
quarterly thereafter the panel shall submit a report regarding the
status of Medicaid managed care in the state and provide recommendations
if it deems appropriate to the governor, the temporary president and the
minority leader of the senate, and the speaker and the minority leader
of the assembly.
* NB Effective until December 31, 2025
* ยง 364-jj. Special advisory review panel on Medicaid managed care.
(a) There is hereby established a special advisory review panel on
Medicaid managed care. The panel shall consist of nine members who shall
be appointed as follows: three by the governor, one of which shall serve
as the chair; two each by the temporary president of the senate and the
speaker of the assembly; and one each by the minority leader of the
senate and the minority leader of the assembly. All members shall be
appointed no later than September first, nineteen hundred ninety-six.
Members shall serve without compensation but shall be reimbursed for
appropriate expenses. The department shall provide technical assistance
and access to data as is required for the panel to effectuate the
mission and purposes established herein.
(b) The panel shall:
(i) determine whether there is sufficient managed care provider
participation in the Medicaid managed care program;
(ii) determine whether managed care providers meet proper enrollment
targets that permit as many Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;
(iii) review the phase-in schedule for enrollment, of managed care
providers under both the voluntary and mandatory programs;
(iv) assess the impact of managed care provider marketing and
enrollment strategies, and the public education campaign conducted in
New York city, on enrollees participation in Medicaid managed care
plans;
(v) evaluate the adequacy of managed care provider capacity by
reviewing established capacity measurements and monitoring actual access
to plan practitioners;
(vi) examine the cost implications of populations excluded and
exempted from Medicaid managed care; and
(vii) examine other issues as it deems appropriate.
(c) Commencing January first, nineteen hundred ninety-seven and
quarterly thereafter the panel shall submit a report regarding the
status of Medicaid managed care in the state and provide recommendations
if it deems appropriate to the governor, the temporary president and the
minority leader of the senate, and the speaker and the minority leader
of the assembly.
* NB Effective December 31, 2025

Structure New York Laws

New York Laws

SOS - Social Services

Article 5 - Assistance and Care

Title 11 - Medical Assistance for Needy Persons

363 - Declaration of Objects.

363-A - Federal Aid; State Plan.

363-B - Agreements for Federal Determination of Eligibility of Aged, Blind and Disabled Persons for Medical Assistance.

363-C - Medicaid Management.

363-D - Provider Compliance Program.

363-E - Medicaid Plan, Applications for Waivers and Plan Amendments; Public Disclosure.

363-E*2 - Preclaim Review for Participating Providers of Medical Assistance Program Services and Items.

363-F - Electronic Visit Verification for Personal Care and Home Health Providers.

364 - Responsibility for Standards.

364-A - Cooperation of State Departments.

364-B - Residential and Medical Care Placement Demonstration Projects.

364-C - National Long Term Care Channeling Demonstration Project.

364-D - Medical Assistance Research and Demonstration Projects.

364-E - Aid to Families With Dependent Children Homemaker/home Health Aide Demonstration Projects.

364-F - Primary Care Case Management Programs.

364-G - Medical Assistance Capitation Rate Demonstration Project.

364-H - Foster Family Care Demonstration Programs for Elderly or Disabled Persons.

364-I - Medical Assistance Presumptive Eligibility Program.

364-J - Managed Care Programs.

364-J-2 - Transitional Supplemental Payments.

364-JJ - Special Advisory Review Panel on Medicaid Managed Care.

364-KK - Condition of Participation.

364-M - Statewide Patient Centered Medical Home Program.

364-N - Diabetes and Chronic Disease Self-Management Pilot Program.

365 - Responsibility for Assistance.

365-A - Character and Adequacy of Assistance.

365-B - Local Medical Plans: Professional Directors.

365-C - Medical Advisory Committee.

365-D - Medicaid Evidence Based Benefit Review Advisory Committee.

365-E - Optional or Continued Membership in Entities Offering Comprehensive Health Services Plans.

365-F - Consumer Directed Personal Assistance Program.

365-G - Utilization Review for Certain Care, Services and Supplies.

365-H - Provision and Reimbursement of Transportation Costs.

365-J - Advisory Opinions.

365-K - Provision of Prenatal Care Services.

365-L - Health Homes.

365-M - Administration and Management of Behavioral Health Services.

365-N - Department of Health Assumption of Program Administration.

365-O - Provision and Coverage of Services for Living Organ Donors.

366 - Eligibility.

366-A - Applications for Assistance; Investigations; Reconsideration.

366-B - Penalties for Fraudulent Practices.

366-C - Treatment of Income and Resources of Institutionalized Persons.

366-D - Medical Assistance Provider; Prohibited Practices.

366-E - Certified Home Health Agency Medicare Billing.

366-F - Persons Acting in Concert With a Medical Assistance Provider; Prohibited Practices.

366-G - Newborn Enrollment for Medical Assistance.

366-H - Automated System; Established.

366-I - Long-Term Care Financing Demonstration Program.

367 - Authorization for Hospital Care.

367-A - Payments; Insurance.

367-B - Medical Assistance Information and Payment System.

367-C - Payment for Long Term Home Health Care Programs.

367-D - Personal Care Need Determination.

367-E - Payment for AIDS Home Care Programs.

367-F - Partnership for Long Term Care Program.

367-G - Authorization and Provision of Personal Emergency Response Services.

367-H - Payment for Assisted Living Programs.

367-I - Personal Care Services Provider Assessments.

367-O - Health Insurance Demonstration Programs.

367-P - Responsibilities of Local Districts for Personal Care Services, Home Care Services and Private Duty Nursing.

367-P*2 - Payment for Limited Home Care Services Agencies.

367-Q - Personal Care Services Worker Recruitment and Retention Program.

367-R - Private Duty Nursing Services Worker Recruitment and Retention Program.

367-S - Long Term Care Demonstration Program.

367-S*2 - Emergency Medical Transportation Services.

367-T - Payment for Emergency Physician Services.

367-U - Payment for Home Telehealth Services.

367-V - County Long-Term Care Financing Demonstration Program.

367-W - Health Care and Mental Hygiene Worker Bonuses.

368 - Quarterly Estimates.

368-A - State Reimbursement.

368-B - State Reimbursement to Local Health Districts; Chargebacks.

368-C - Audit of State Rates of Payment to Providers of Health Care Services.

368-D - Reimbursement to Public School Districts and State Operated/state Supported Schools Which Operate Pursuant to Article Eighty-Five, Eighty-Seven or Eig

368-E - Reimbursement to Counties for Pre-School Children With Handicapping Conditions.

368-F - Reimbursement of Costs Under the Early Intervention Program.

369 - Application of Other Provisions.