Table of Contents
Search
How Do I...

Search Tips

Table of Contents Search

  • For more specific results, select both a chapter and section.
  • To move from section to section within a chapter, use the left navigation bar.

Keyword Search

  • For best results, select a recommended search term if one appears in the search box.
  • To narrow your search, use the Filter By and Additional Keywords features in the left navigation bar.
  • To find an exact phrase, use quotes (e.g., “prior approval”).
  • To find all search terms, use the word AND in capital letters between search terms.
  • To find at least one search term, use the word OR in capital letters between search terms.
×
  • Regulatory Mandatory Reporting > Agencies

    To ensure public safety and track conditions that affect public health, New York State agencies, NYSDOH and NYCDOHMH have enacted laws practitioners must follow. Our network practitioners are required to participate in these government reporting procedures and, as part of this mandate, may need to report to one or more of the following agencies:

    • Centers for Disease Control and Prevention (CDC)
    • Food and Drug Administration (FDA)
    • New York City Department of Health and Mental Hygiene (NYCDOHMH)
    • New York State Cancer Registry (NYSCR)
    • New York State Central Register (SCR) of Child Abuse and Maltreatment
    • New York State Department of Health (NYSDOH)
    • New York State Immunization Information System (NYSIIS)
    • New York State Penal Code
    • New York State Pesticide Poisoning Registry
    • New York State Rules and Regulations on Controlled Substances-Public Health Law
    • NYCDOHMH Citywide Immunization Registry (CIR)
    • NYCDOHMH Lead Poisoning Prevention Program (LPPP)
    • NYSDOH Alzheimer's Disease and Other Dementias Registry
    • NYSDOH Bureau of Communicable Disease Control
    • NYSDOH Bureau of Occupational Health - Occupational Lung Disease Registry
    • NYSDOH Center for Environmental Health
    • NYSDOH Congenital Malformations Registry
    • NYSDOH Division of Quality and Surveillance for Nursing Homes and ICFs/MR (DQS)
    • NYSDOH Hospital Complaints
    • NYSDOH Office of Professional Medical Conduct

    My Subscriptions

    Enter your e-mail address to receive a link to your subscriptions.

    Submit
    ×

    Glossary terms found on this page:

    Initial oral or written communication from a member or their designee or provider that expresses discontent with any aspect of their care or coverage with EmblemHealth. Specifically, it is dissatisfaction with:

    • A determination made by the plan, other than a determination of medical necessity or a determination that a service is considered experimental or investigational
    • Treatment experienced through the plan, its providers or contractors
    • Any concern with the plan, its benefits, employees or providers.

    A health care benefit arrangement that is similar to a preferred provider organization in administration, structure and operation but does not cover out-of-network care. Also called an Exclusive Provider Organization.

    An institution which provides inpatient services under the supervision of a physician, and meets the following requirements:

    • Provides diagnostic and therapeutic services for medical diagnosis, treatment and care of injured and sick persons and has, as a minimum, laboratory and radiology services and organized departments of medicine and surgery
    • Has an organized medical staff which may include, in addition to doctors of medicine, doctors of osteopathy and dentistry
    • Has bylaws, rules and regulations pertaining to standards of medical care and service rendered by its medical staff
    • Maintains medical records for all patients
    • Has a requirement that every patient be under the care of a member of the medical staff
    • Provides 24-hour patient services
    • Has in effect agreements with a home health agency for referral and transfer of patients to home health agency care when such service is appropriate to meet the patient's requirements

    An organization comprised of individual physicians or physicians in group practices that contracts with the managed care organization on behalf of its member physicians to provide health care services. Also called an Independent Practice Association.

    Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.

    Conditions that affect thinking and the ability to figure things out that affect perception, mood and behavior.

    The group of physicians, hospital, and other medical care providers that a specific plan has contracted with to deliver medical services to its members.

    A public agency that works to control the spread of infectious diseases, monitor the health of New Yorkers and create an environment that protects and promotes health by using regulations, education and advocacy and providing direct health services. Also known as NYCDOHMH.

    The state regulatory agency that certifies reimbursement methods and rates to hospitals and reviews HMO activities in the state of New York. Also called NYSDOH.

    A public agency that works to control the spread of infectious diseases, monitor the health of New Yorkers and create an environment that protects and promotes health by using regulations, education and advocacy and providing direct health services. Also known as the New York City Department of Health and Mental Hygiene.

    The state regulatory agency that certifies reimbursement methods and rates to hospitals and reviews HMO activities in the state of New York. Also called the New York State Department of Health.

    New York State Department of Health. This agency provides information for consumers, doctors, researchers and health care providers.

    ×

You are now leaving the Medicare section of the EmblemHealth website.

Click to Continue ×

Your member ID # is on the front of your ID card.