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    • 1-800-542-2437
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    • 1-800-962-5065

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      • 1-866-637-2342
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Section 2: Enrollment Information

Enrollment is limited to health facilities, (hospitals and diagnostic and treatment centers), which are:

  1. licensed under Article 28 of the Public Health Law;
  2. approved to participate in the New York State Medicaid Program, and
  3. have signed an agreement with the New York State Department of Health to provide comprehensive services and coordination of care for persons with HIV.

The HIV Primary Care Medicaid Agreement

The HIV Primary Care Medicaid Agreement consists of two parts. The Agreement has been revised to reflect program changes effective November 1, 2006. All facilities currently enrolled in the program must sign a new Agreement and return it to the New York State Department of Health by January 1, 2007. Facilities wishing to enroll or continue participating in the program must sign Part 1 and complete and sign Part 2 and mail them to the address provided below.

  • Part 1, the body of the Agreement (PDF, 86KB, 5pg.), sets forth facility responsibilities for providing or arranging for continuous and comprehensive HIV primary care. These responsibilities include intensive follow up on referrals and missed appointments. Part 1 must be signed by both the facility and the New York State Department of Health. Part 1 also includes brief descriptions of the five visits reimbursable under the program.
  • Part 2, the HIV Primary Care Information Form (PDF, 52KB, 2pg.) , requests specific information on the facility's plan for administering and delivering HIV primary care services.

Enrollment Options

Facilities enrolling in the program may choose to provide one of two HIV Primary Care Medicaid Program service packages:

  • HIV testing only, which includes the following visits:
    • HIV Testing,
    • HIV Counseling without Testing ,
    • HIV Counseling (Positive);
  • HIV testing and clinical services, which includes all five HIV Primary Care Medicaid Program visits. A facility enrolling to provide clinical services must possess an operating certificate for primary medical care.

Facilities offering HIV testing only must have a written referral agreement with another Article 28 facility offering HIV clinical services or with an HIV Special Needs Plan.

HIV Testing in Part-Time Clinics

Facilities participating in the HIV Primary Care Medicaid Program may apply for approval to bill for HIV testing visits provided in part-time clinics. Department approval may be obtained by sending a request to add HIV testing rate codes to the contact address listed below. The request must specify the location of the part-time clinic and provide the unique part-time clinic billing ID number.

Enrollment Instructions

A facility wishing to enroll in the HIV Primary Care Medicaid Program should send the signed and completed Agreement, (Parts 1 and 2) along with a copy of the facility's operating certificate to:

HIV Primary Care Medicaid Program
Division of HIV Health Care & Community Services
New York State Department of Health
AIDS Institute
Empire State Plaza
Corning Tower - Room 459
Albany, NY 12237