N.Y. Social Services Law § 365-e: Optional or continued membership in entities offering comprehensive health services plans

§ 365-e. Optional or continued membership in entities offering

comprehensive health services plans. 1. In accordance with applicable

federal requirements and subject to the approval of the commissioner and

the director of the budget, a district shall offer to persons eligible

for medical assistance the option of membership in any health

maintenance organization or other entity which is certified under

article forty-four of the public health law or licensed pursuant to

article nine-C of the insurance law or otherwise authorized by law, and

which offers comprehensive health services plans to persons residing

within the social services district unless granted a waiver by the

commissioner on the grounds that the organization or entity is not

geographically accessible so as to provide medical assistance to

eligible recipients who reside within the district or that the per

recipient capitation rate is above the expected average per recipient

fee-for-service cost within the local district or that the health

maintenance organization or other entity refuses to enter into a

contract with the district.

2. Nothwithstanding any inconsistent provision of law, persons who,

prior to becoming eligible for medical assistance, are enrolled in a

health maintenance organization or other entity offering a comprehensive

health services plan shall be offered the option of continuing that

enrollment.

3. The commissioner shall offer to social services districts such

technical assistance as may be appropriate to assist in the development

of contracts between the districts and such entities.