New York Codes, Rules and Regulations (NYCRR)

Title 18 Part 360

Department of Social Services

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18 NYCRR 360-1.1 - Introduction

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18 NYCRR 360-1.2 - Applicability of other rules and regulations to medical assistance (MA)

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18 NYCRR 360-1.3 - Brief overview of eligibility

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18 NYCRR 360-1.4 - Definitions

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18 NYCRR 360-2.1 - Introduction

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18 NYCRR 360-2.2 - Applying for MA

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18 NYCRR 360-2.3 - Investigation of eligibility

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18 NYCRR 360-2.4 - Decision

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18 NYCRR 360-2.5 - Notification of acceptance/denial

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18 NYCRR 360-2.6 - Changes in circumstances affecting classification or eligibility

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18 NYCRR 360-2.7 - Termination of MA; notification of discontinuance

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18 NYCRR 360-2.8 - Right to a conference

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18 NYCRR 360-2.9 - Right to a fair hearing

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18 NYCRR 360-3.1 - Introduction

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18 NYCRR 360-3.2 - Conditions of eligibility

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18 NYCRR 360-3.3 - Who is eligible for MA

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18 NYCRR 360-3.4 - Who is excluded from receiving MA

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18 NYCRR 360-3.5 - MA for State residents outside their district of residence

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18 NYCRR 360-3.6 - Eligibility of persons temporarily in the State

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18 NYCRR 360-3.7 - Presumptive eligibility

Related State Register notice: Revised rulemaking HLT-28-14-00008-RP. Published Feb 25, 2015.

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18 NYCRR 360-3.8 - Earlier source heading: [Repealed]

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18 NYCRR 360-4.1 - Introduction

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18 NYCRR 360-4.2 - Size of MA household

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18 NYCRR 360-4.3 - Available income

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18 NYCRR 360-4.4 - Available resources

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18 NYCRR 360-4.5 - Availability of assets held in trust

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18 NYCRR 360-4.6 - Net available income and resources

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18 NYCRR 360-4.7 - Standard exemptions

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18 NYCRR 360-4.8 - Determination of financial eligibility; effect of excess income and resources on eligibility

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18 NYCRR 360-4.9 - Post-eligibility utilization of income

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18 NYCRR 360-4.10 - Treatment of income and resources of institutionalized spouses

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18 NYCRR 360-5.1 - Introduction

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18 NYCRR 360-5.2 - Definitions

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18 NYCRR 360-5.3 - Medical criteria for disability determination

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18 NYCRR 360-5.4 - Reapplication

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18 NYCRR 360-5.5 - Examination

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18 NYCRR 360-5.6 - Grandfathered cases

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18 NYCRR 360-5.7 - Pending of disability cases

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18 NYCRR 360-5.8 - Effective date of disability

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18 NYCRR 360-5.9 - Trial work period

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18 NYCRR 360-5.10 - Medically determined drug addicts and alcoholics

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18 NYCRR 360-5.11 - Evaluation of disability

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18 NYCRR 360-5.12 - Determination of blindness status

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18 NYCRR 360-6.1 - Introduction

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18 NYCRR 360-6.2 - Authorization for MA

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18 NYCRR 360-6.3 - Free choice by recipient guaranteed

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18 NYCRR 360-6.4 - Restriction of recipient access to services (recipient restriction program)

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18 NYCRR 360-6.5 - Fair hearing requirements in utilization review cases

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18 NYCRR 360-6.6 - Where care and services may be provided

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18 NYCRR 360-6.7 - Earlier source heading: [Repealed]

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18 NYCRR 360-6.8 - Medical care coordinator program (MCCP)

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18 NYCRR 360-7.1 - Introduction

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18 NYCRR 360-7.2 - MA program as payment source of last resort

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18 NYCRR 360-7.3 - Use of health, hospital or accident insurance

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18 NYCRR 360-7.4 - Liability of third parties

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18 NYCRR 360-7.5 - Method of payment for medical care

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18 NYCRR 360-7.6 - Payment for services or supplies

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18 NYCRR 360-7.7 - Payments of deductibles and coinsurance under title XVIII of the Social Security Act (Medicare)

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18 NYCRR 360-7.8 - Payments of premiums under title XVIII of the Social Security Act (Medicare)

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18 NYCRR 360-7.9 - Special needs of MA recipients subject to chronic care budgeting

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18 NYCRR 360-7.10 - Earlier source heading: [Repealed]

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18 NYCRR 360-7.11 - Medical assistance liens and recoveries

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18 NYCRR 360-7.12 - Co-payments by recipients

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18 NYCRR 360-8.1 - Confidentiality of HIV- and AIDS-related information

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18 NYCRR 360-9.1 - Scope

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18 NYCRR 360-9.2 - Demonstration applications

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18 NYCRR 360-9.3 - Definitions

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18 NYCRR 360-9.4 - Eligibility for the CHCEP services

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18 NYCRR 360-9.5 - Responsibilities of the CHCEP applicant and recipient

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18 NYCRR 360-9.6 - Powers and responsibilities of the social services district

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18 NYCRR 360-9.7 - Powers and responsibilities of the department

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18 NYCRR 360-10.1 - Introduction

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18 NYCRR 360-10.2 - Scope

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18 NYCRR 360-10.3 - Definitions

Related State Register notice: Proposed rule HLT-27-20-00006-P. Published Jul 8, 2020.

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18 NYCRR 360-10.4 - Individuals required to enroll in an MMCO

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18 NYCRR 360-10.5 - Individuals exempt or excluded from enrollment in an MMCO

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18 NYCRR 360-10.6 - Good cause for changing or disenrolling from an MMCO

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18 NYCRR 360-10.7 - Good cause for changing primary care practitioners

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18 NYCRR 360-10.8 - Fair hearings

Related State Register notice: Proposed rule HLT-27-20-00006-P. Published Jul 8, 2020.

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18 NYCRR 360-10.9 - Marketing/outreach

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18 NYCRR 360-10.10 - MMCO unacceptable practices

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18 NYCRR 360-10.11 - MMCO sanctions and due process

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18 NYCRR 360-10.12 - Earlier source heading: [Repealed]

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