Medicaid Managed Care & Family Health Plus Model Contract

This contract was used to establish Medicaid managed care operations in New York State. The terms of this contract are active from October 1, 2005, through September 30, 2008. The contract has an additional two-year renewal period if approved by the New York State Department of Health, the Department of Health and Human Services, and the Office of the State Comptroller.

It details the general contract administration provisions and the agreement term. Compensation methods and rate setting methodology are presented. The enrollment, lock-in, and disenrollment provisions are presented. The benefit packages are detailed for a variety of populations such as: children enrolled in a Child/Teen Health program or adolescent preventative services, foster care children, children involved with child protective services, people involved with adult protective services, and court-ordered services. The benefit plans also describe how enrollees can self-refer for mental health and chemical dependence services and the services available to people with chronic illnesses and physical or developmental disabilities.