PDF INFORMATION FOR ALL PROVIDERS MANAGED CARE INFORMATION - eMedNY

Information for All Providers ? Managed Care Information

NEW YORK STATE MEDICAID PROGRAM

INFORMATION FOR ALL PROVIDERS MANAGED CARE INFORMATION

Information for All Providers ? Managed Care Information

Table of Contents

PREPAID CAPITATION PLANS (PCP) .................................................................................................... 3 COUNTY/DISTRICT CODES ..................................................................................................................... 7

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Information for All Providers ? Managed Care Information

Prepaid Capitation Plans (PCP)

Key:

Plan Type Abbreviation Partial LTC LTC Pace Medicaid Adv Plus FHP SNP Mainstream Medicaid Advantage FIDA IDD

HARP

descri ptio n

Model Contract Link

Long Term Care: Partial Capitation



ial_capit atio n_model.pdf

Long Term Care: PACE



e_model_co nt ract .pdf

Long Term Care: Medicaid Advantage

Plus

dic aid_adv _plus_model_co ntract .pdf

Family Health Plus



naged_c are_f hp_hiv -s np_model_co ntract.pdf

Special Needs Plan



naged_c are_f hp_hiv -s np_model_co ntract.pdf

Medical Assistance



naged_c are_f hp_hiv -s np_model_co ntract.pdf

Medicaid Advantage



dic aid_adv ant age_model_co ntract .pdf

Fully Integrated Duals Advantage Plan ?

Intellectual and Developmental Disabilities _management/FIDA_IDD

Health and Recovery Plan

naged_c are_f hp_hiv -s np_model_co ntract.pdf

Plan Code 82 92 AA AC

AF AG

AH

AP

AZ

C2 C7

CC

CD CG

Plan ID# 00477156 00894519 04004537 03114514

04342307 03481927

03458546

03466800

05572692

01249265 01234037

03320725

04342316 01183013

PCP Provider Name Affinity Health Plan, Inc. Metroplus Health Plan, Inc. Healthplus HP LLC ArchCare Senior Life (Catholic Managed Long Term Care Inc) Affinity Health Plan ? Enriched Plan AgeWell New York, LLC

Aetna Better Health

Archcare Community Life (Catholic Managed LTCS MLTC) AgeWell MAP (Age Well New York MAP LLC) HealthNow NY, Inc. (Community Blue) CenterLight HealthCare PACE

Complete Senior Care Inc

Capital District Physician's Health Plan Capital District Physician's Health Plan

Telephone Number (800) 553-8247 (800) 597-3380 (800) 454-3730 (866) 263-9083 TTY (800) 662-1220

(800) 553-8247 (866) 586-8044 TTY (800) 662-1200

(855) 456-9126 TTY (711)

(866) 467-9351 TTY (711)

(866)237-3210 TTY (800) 662-1200

(716) 887-6900 (877) 226-8500 TTY (800) 650-2774

(888)303-4333 TTY (716) 285-8248

(518) 641-3500 (800) 926-7626

Plan Type Mainstream Mainstream HARP LTC Pace

HARP Partial LTC

Partial LTC

Partial LTC

Medicaid Adv Plus Mainstream LTC Pace

LTC Pace

HARP Mainstream

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Plan Code Plan ID# PCP Provider Name

CH

03072740 Catholic Health Life PACE

CP

03506989 Centers Plan for Healthy Living

CM

05357520 Centers Plan for Medicaid Advantage

Plus

EA

05410146 Elderserve Health MAP, INC

E7

01674982 Senior Care Connection

EC

03549135 Extended MLTC LLC

ED

03253707 Elderplan, Inc., Homefirst

EE

04342343 Excellus ? Blue Option Plus - HARP

EG

03690851 KALOS Health

(ErieNiagara MLTCP Inc)

EH

03234044 RiverSpring at Home

(Elderserve Health Inc)

FZ

04190745 Fallon Health Weinberg PACE

GD

01788325 Fidelis Care at Home

HA

06259723 Hamaspik MAP INC

H1

02104369 Senior Health Partners

(Healthfirst PHSP, Inc)

HC

03522947 Hamaspik Choice

HF HI HT,98,99 HW HY IC

IE

04003696 Healthfirst PHSP Person Wellness Plan 04082293 HIP of Greater NY 00313979 HIP of Greater NY 01131584 HIP Westchester 01202822 HIP Nassau 03866960 iCircle Service of the Finger Lakes

01208997 Independent Health Association

Telephone Number (855) 671-3341 TTY (716) 819-5084

(855) 270-1600 TTY (800) 421-1220

(833)-274-5627 TTY: 1800 421 1220

1-800-580-7000 TTY/TDD: 711 (855) 376-7888 TTY (800) 662-1220

(866) 389-2656 (855) 899-6492

(866) 389-2656 TTY (800) 662-1220

(800) 894-2464 TTY (800) 662-1220

(800) 370-3600 TTY (866) 236-5800

(855) 665-1113 (TTY 711)

(888) 343-3547 TTY (800) 695-8544

(855) 552-4642 TTY/TDD: (855) 8544030 (866) 585-9280 TTY (800) 662-1220 (855) 552-4642 TTY (877) 544-6220 (866) 463-6743

(646) 447-5000

(646) 447-5000

(646) 447-5000

(646) 447-5000

(844) 424-7253 TTY (711) (800) 736-5771

Plan Type LTC Pace

Partial LTC

Medicaid Adv Plus Medicaid Adv Plus LTC Pace

Partial LTC

Partial LTC

HARP Partial LTC

Partial LTC

LTC PACE

Partial LTC

Medicaid Adv Plus Partial LTC

Partial LTC

HARP HARP Mainstream Mainstream Mainstream Partial LTC Mainstream

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Information for All Providers ? Managed Care Information

Plan Code IH

IL

IP

IS

IT

KP KX

M3

MA

MC MF

MH

MO MP

MR MT MV MZ

N6

NA

NC OD OM PC

PO

SF SP SP

Plan ID# 04342325

01278899

05922454

PCP Provider Name

Independent Health's MediSource Connect - HARP ElderOne (Independent Living for Seniors) Integra MLTC Inc MAP

01519162 PACE CNY (Loretto HMO)

03475427 Integra MLTC, Partial Cap

01617894 Healthplus HP, LLC 02644562 Healthplus HP, LLC

01825947 Evercare Choice

04342334

06097149 03594052

MVP Harmonious Health Care Plan HARP MetroPlus Health Ultracare

Montefiore HMO

03420808

01403176 03466906

HealthFirst Complete Care (HealthFirst Health Plan) United HealthCare of NY, Inc.

MetroPlus MLTC

00477023 04053201 01111375

01778523

Excellus Metroplus Health Plan Inc. MVP, Inc.

Senior Network Health

02188296 Fallon Health Weinberg

04122776 Elderwood (Niagara Advantage Health Plan)

04004486 HealthierLife

02191582 02191362 03581413

Amida Care Inc., (VidaCare, Inc., SN) Metroplus Partnership Care SN Prime Health Choice

04099212 Partners Health Plan

01479670 01421250 01751046

HealthFirst PHSP, Inc. Fidelis Care New York Fidelis Care New York

Telephone Number

(855) 457-4636 TTY (800) 662-1220 (877) 388-5195

(888) 728-7223 TTY (800) 662-1220 (855) 661-0002 TTY (711) (800) 454-3730 (866) 805-4589 TTY (800) 855-2880 (877) 255-3678 (845) 569-2228

855-552-4642 (855) 556-6683 TTY (711) (888) 260-1010 TTY (888) 542-3821 (877) 842-3210 (855) 355-6582 TTY (800) 881-2812 (800) 920-8889 (800) 597-3380 (800) 684-9286

(888) 355-4764 TTY (800) 662-1220 (716) 250-3100 (866) 882-8185 (866) 843-7526 TTY (711) (800) 749-0820

(646) 786-1800 (800) 303-9626 (855) 777-4630 TTY (855) 777-4613 (855) 747-5483 TTY (711) (866) 463-6743 (800) 749-0820 (800) 749-0820

Plan Type HARP

LTC Pace

Medicaid Adv Plus LTC Pace

Partial LTC

Mainstream Partial LTC

Partial LTC

HARP

MC Partial LTC

Medicaid Adv Plus Mainstream Partial LTC

Mainstream HARP Mainstream Partial LTC

Partial LTC

Partial LTC

HARP SNP SNP Partial LTC

FIDA-IDD

Mainstream Mainstream Mainstream

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Information for All Providers ? Managed Care Information

Plan Code SW TN TO TS UC VA VC VL VM VS YD YF YH YL YN YO YU YW

Plan ID# PCP Provider Name 03459881 Senior Whole Health

04342292 03685774

03056544

Molina Healthcare Plan of NY

Molina Healthcare of New York Inc. (TONY) Total Senior Care PACE

04054091 03529059

01750467

United Healthcare of New York

Nascentia Health (VNA Homecare Options) VNS Choice

03420399 Village Care Max

04682248 VillageCareMAX Total Advantage

03420871 VNS Choice Select Health SNP

Telephone Number

(877) 353-0185 TTY (711)

(315) 476-7921

(866) 939-8613 TTY (800) 662-1220 (877) 842-3210 (855) 877-8868 TTY (711) (888) 867-6555 TTY (711) (800) 469-6292 TTY (800) 662-1220 (800) 469-6292 TTY (800) 662-1220 (866) 469-7774

02738989 Fidelis Care Dual

(718) 896-6500

02927631 02932896 03173113 02914056 03173080 03238240

Fidelis Care MAP

Senior Whole Health MAP

Elderplan MAP

VNS Choice Plus M/M

Empire MediBlue HealthPlus Dual Plus (HMO D-SNP) (HealthPlus HP) United HealthCare of New York

(877) 533-2404 TTY (800)558-1125 (877) 353-0185 TTY (711) (866) 386-9437 TTY (800) 662-1220 (866) 597-6674 TTY 711 (866) 805-4589 TTY (800) 855/2880 (866) 362-3368

02645710 Wellcare of New York M/M

(866) 491-5746

Plan Type Partial LTC

HARP Mainstream

LTC Pace

HARP Partial LTC

Partial LTC

Partial LTC

Medicaid Adv Plus SNP

Medicaid Advantage Medicaid Adv Plus Medicaid Adv Plus Medicaid Adv Plus Medicaid Adv Plus Medicaid Adv Plus Medicaid Advantage Medicaid Advantage

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Information for All Providers ? Managed Care Information

County/District Codes

Below is a listing of all the counties and their corresponding district codes.

01 Albany 02 Allegany 03 Broome 04 Cattaraugus 05 Cayuga 06 Chautauqua 07 Chemung 08 Chenango 09 Clinton 10 Columbia 11 Cortland 12 Delaware 13 Dutchess 14 Erie 15 Essex 16 Franklin 17 Fulton 18 Genesee 19 Greene 20 Hamilton 21 Herkimer 22 Jefferson 23 Lewis 24 Livingston 25 Madison 26 Monroe 27 Montgomery 28 Nassau 29 Niagara 30 Oneida 31 Onondaga 32 Ontario 33 Orange

34 Orleans 35 Oswego 36 Otsego 37 Putnam 38 Rensselaer 39 Rockland 40 St. Lawrence 41 Saratoga 42 Schenectady 43 Schoharie 44 Schuyler 45 Seneca 46 Steuben 47 Suffolk 48 Sullivan 49 Tioga 50 Tompkins 51 Ulster 52 Warren 53 Washington 54 Wayne 55 Westchester 56 Wyoming 57 Yates 66 New York City 97 Office of Mental Health

Administered 98 Office for People with

Developmental Disabilities 99 Breast & Cervical Cancer

Treatment Program

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