New York Medicaid
Complete guide to New York Medicaid enrollment, managed care plans, and provider requirements
Enrollment Time
60-90 Days
MCOs
8+ Plans
Timely Filing
365 Days
Model
Managed Care
New York Medicaid Overview
New York Medicaid serves over 7 million beneficiaries, making it one of the largest state programs. Nearly all beneficiaries are enrolled in managed care plans, with the majority concentrated in the New York City metro area.
Key New York Features:
- • Strong Prompt Pay Laws: NYS requires payment within 45 days
- • Mental Health Parity: Aggressive enforcement of mental health coverage
- • Independent Dispute Resolution: Available for out-of-network disputes
- • Regional Plans: Different plans available in NYC vs upstate regions
Provider Enrollment Process
Step-by-Step NY Medicaid Enrollment
1. Enroll with NYS Medicaid
Complete enrollment with the New York State Department of Health:
- • Submit online application through eMedNY
- • Provide NY license, NPI, TIN, and supporting documents
- • Complete required attestations
- • Processing time: 45-75 days
Important NY Requirement
New York requires providers to complete MHCP (Mandatory Health Care Professionals) training on infection control and identifying victims of human trafficking.
2. Contract with Managed Care Plans
After state enrollment, credential with individual MCOs:
- • Focus on plans operating in your region
- • Submit credentialing applications (most use CAQH)
- • NY-specific provider agreements required
- • Processing time: 60-90 days per plan
Total Timeline
- • NYS Medicaid enrollment: 45-75 days
- • MCO credentialing: 60-90 days per plan
- • Total: 105-165 days from start to billing
New York Medicaid Managed Care Plans
Note: Plan availability varies by region. NYC has the most plan choices. Upstate regions typically have 3-5 plans available.
Affinity Health Plan
Amida Care
Empire BlueCross BlueShield HealthPlus
Fidelis Care
HealthFirst
MetroPlus Health Plan
Molina Healthcare of New York
UnitedHealthcare Community Plan
Provider tip: Fidelis Care and HealthFirst have the largest enrollment in NYC. Empire BCBS and UnitedHealthcare have strong upstate presence.
Behavioral Health Services
NY Medicaid Behavioral Health Coverage
New York has strong mental health parity enforcement and comprehensive behavioral health coverage through managed care plans.
Covered BH Services
- • Outpatient therapy (individual, group, family)
- • Psychiatric services and medication management
- • Intensive outpatient programs (IOP)
- • Partial hospitalization programs (PHP)
- • Residential treatment facilities
- • OASAS-certified SUD treatment programs
- • Peer support and recovery services
- • Crisis intervention services
Mental Health Parity in NY
New York has some of the strongest mental health parity laws in the nation. Plans cannot impose more restrictive limitations on behavioral health services than on medical/surgical services. This includes visit limits, prior authorization requirements, and reimbursement rates.
OASAS Certification
Substance use disorder programs must be certified by the NYS Office of Addiction Services and Supports (OASAS) to bill Medicaid. This is separate from Medicaid enrollment.
Important Contacts
NYS Department of Health
OASAS (Substance Use Services)
General Information
1-877-846-7369
OASAS Website
OASAS.ny.gov