Reminder: Medicaid Provider

Date Issued: 8/27/2015

As a reminder, Medicaid providers and their employees or contractors cannot interfere with the rights of Medicaid recipients in making decisions about their health care coverage. Medicaid providers and their employees or contractors are free to inform recipients about their contractual relationships with Medicaid managed care programs, including Fully Integrated Duals Advantage (FIDA). However, they are prohibited from directing, assisting or persuading recipients on which plan to choose or keep.

In addition, if a Medicaid recipient expresses interest in a Medicaid managed care program, providers and their employees or contractors must not dissuade or limit the recipient from obtaining information about these programs. Instead, they should direct the recipient to New York Medicaid Choice, New York State’s enrollment broker responsible for providing Medicaid recipients with eligibility and enrollment information for all managed long-term care plans. The phone number is 1-888-401-6582. Hours of operation are: Monday through Friday, 8:30 am to 8 pm and Saturdays from 10 am
to 6 pm.

If a violation is suspected, it will be turned over to the New York Office of the Medicaid Inspector General (OMIG) and potentially the Federal Office of Inspector General (OIG) for investigation.