New York Codes, Rules and Regulations (NYCRR)
Title 10 Part 98
Department of Health
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Source versions current through Dec 15, 2021 - Mar 15, 2022 across sections
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10 NYCRR 98-1.1 - Applicability
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10 NYCRR 98-1.2 - Definitions
Related State Register notice: Adopted rule HLT-40-14-00018-A. Published Sep 23, 2015. Notice effective date: Sep 23, 2015.
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- NYCRR title agency
- Department of Health
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- Related Register notice
- HLT-40-14-00018-A · Adopted rule
- Related notice published
- Sep 23, 2015
- Related notice effective date
- Sep 23, 2015
Current section text is not available here.
10 NYCRR 98-1.3 - Earlier source heading: Reserved
Related State Register notice: Adopted rule HLT-02-24-00008-A. Published Feb 26, 2025. Notice effective date: Jul 1, 2025.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-02-24-00008-A · Adopted rule
- Related notice published
- Feb 26, 2025
- Related notice effective date
- Jul 1, 2025
Current section text is not available here.
10 NYCRR 98-1.4 - Certificate of incorporation or articles of organization
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10 NYCRR 98-1.5 - Application for a certificate of authority
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10 NYCRR 98-1.6 - Issuance of a certificate of authority
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10 NYCRR 98-1.7 - Limitations of a certificate of authority
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10 NYCRR 98-1.8 - Continuance of a certificate of authority
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10 NYCRR 98-1.9 - Acquisition or retention of control of MCOs
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10 NYCRR 98-1.10 - Transactions within a holding company system affecting controlled MCOs
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10 NYCRR 98-1.11 - Earlier source heading: Operational and financial requirements for MCOs
Related State Register notice: Adopted rule HLT-02-24-00008-A. Published Feb 26, 2025. Notice effective date: Jul 1, 2025.
Source version current through Mar 15, 2022
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Source version current through
- Mar 15, 2022
- Related Register notice
- HLT-02-24-00008-A · Adopted rule
- Related notice published
- Feb 26, 2025
- Related notice effective date
- Jul 1, 2025
Current section text is not available here.
10 NYCRR 98-1.12 - Quality management program
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- Department of Health
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10 NYCRR 98-1.13 - Assurance of access to care
Related State Register notice: Adopted rule HLT-02-24-00008-A. Published Feb 26, 2025. Notice effective date: Jul 1, 2025.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-02-24-00008-A · Adopted rule
- Related notice published
- Feb 26, 2025
- Related notice effective date
- Jul 1, 2025
Current section text is not available here.
10 NYCRR 98-1.14 - Enrollee services and grievance procedures
Source version current through Dec 15, 2021
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- Department of Health
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10 NYCRR 98-1.15 - Employer requirements
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10 NYCRR 98-1.16 - Disclosure and filing
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
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- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-1.17 - Audits and examinations
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10 NYCRR 98-1.18 - Relationship between an MCO and an IPA
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10 NYCRR 98-1.19 - Marketing by MLTCPs
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- Department of Health
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10 NYCRR 98-1.20 - Waved requirements for MLTCPs
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10 NYCRR 98-1.21 - Fraud and abuse prevention plans and special investigation units
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10 NYCRR 98-1.22 - Warning statements
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10 NYCRR 98-2.1 - Preamble
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10 NYCRR 98-2.2 - Definitions
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10 NYCRR 98-2.3 - Standard description of the external appeal process
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10 NYCRR 98-2.4 - Certification of external appeal agents
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10 NYCRR 98-2.5 - Certification requirements
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10 NYCRR 98-2.6 - Conflict of interest
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10 NYCRR 98-2.7 - Screening of requests for external appeal
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10 NYCRR 98-2.8 - Random assignment of external appeals
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10 NYCRR 98-2.9 - Responsibilities of health care plans
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10 NYCRR 98-2.10 - Responsibilities of certified external appeal agents
Related State Register notice: Proposed rule HLT-27-20-00006-P. Published Jul 8, 2020.
Source version current through Mar 15, 2022
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- Department of Health
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- Mar 15, 2022
- Related Register notice
- HLT-27-20-00006-P · Proposed rule
- Related notice published
- Jul 8, 2020
Current section text is not available here.
10 NYCRR 98-2.11 - Enrollee rights and responsibilities
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10 NYCRR 98-2.12 - Confidentiality
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10 NYCRR 98-2.13 - Audits and examinations
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- Department of Health
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10 NYCRR 98-3.1 - Purpose
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
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- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.2 - Definitions
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Mar 15, 2022
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- NYCRR title agency
- Department of Health
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- Source version current through
- Mar 15, 2022
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.3 - General requirements related to filing of annual audited financial reports and audit committee appointment
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.4 - Contents of annual audited financial report
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.5 - Designation of CPA
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
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- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.6 - Qualifications of CPA
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
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- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.7 - Consolidated or combined audits
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.8 - Scope of audit and report of CPA
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.9 - Notification of adverse financial condition
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.10 - Communication of internal control related matters noted in an audit
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.11 - CPA’s letter of qualifications
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.12 - Availability and maintenance of CPA work papers
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
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- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.13 - Requirements for audit committees
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.14 - Conduct of MCO in connection with the preparation of required reports and documents
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.15 - Management’s report of internal control over financial reporting
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Mar 15, 2022
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Mar 15, 2022
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-3.16 - Effective date and special rules
Related State Register notice: Adopted rule HLT-42-14-00001-A. Published Nov 10, 2015. Notice effective date: Nov 10, 2015.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-42-14-00001-A · Adopted rule
- Related notice published
- Nov 10, 2015
- Related notice effective date
- Nov 10, 2015
Current section text is not available here.
10 NYCRR 98-4.1 - Purpose
Related State Register notice: Adopted rule HLT-27-20-00007-A. Published Sep 30, 2020. Notice effective date: Dec 29, 2020.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-27-20-00007-A · Adopted rule
- Related notice published
- Sep 30, 2020
- Related notice effective date
- Dec 29, 2020
Current section text is not available here.
10 NYCRR 98-4.2 - Applicability
Related State Register notice: Adopted rule HLT-27-20-00007-A. Published Sep 30, 2020. Notice effective date: Dec 29, 2020.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
- Section source receipt
- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-27-20-00007-A · Adopted rule
- Related notice published
- Sep 30, 2020
- Related notice effective date
- Dec 29, 2020
Current section text is not available here.
10 NYCRR 98-4.3 - Definitions
Related State Register notice: Adopted rule HLT-27-20-00007-A. Published Sep 30, 2020. Notice effective date: Dec 29, 2020.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
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- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-27-20-00007-A · Adopted rule
- Related notice published
- Sep 30, 2020
- Related notice effective date
- Dec 29, 2020
Current section text is not available here.
10 NYCRR 98-4.4 - Mental health and substance use disorder parity compliance program
Related State Register notice: Adopted rule HLT-27-20-00007-A. Published Sep 30, 2020. Notice effective date: Dec 29, 2020.
Source version current through Dec 15, 2021
Dates and status
- NYCRR title agency
- Department of Health
- Section status
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- Section text
- Sign in to read this section
- Source version current through
- Dec 15, 2021
- Related Register notice
- HLT-27-20-00007-A · Adopted rule
- Related notice published
- Sep 30, 2020
- Related notice effective date
- Dec 29, 2020
Current section text is not available here.