Provider Contract Guidelines for MCOs and IPAs
Note: Effective March 1, 2011, all contracts, material amendments and templates between plans and providers; plans and IPAs; IPAs and providers; and IPAs and IPAs, must be submitted to the Department of Health for review and approval in accordance with the revised Provider Contract Guidelines for MCOs and IPAs. The Standard Clauses for Managed Care Provider/IPA Contracts and the Provider Contract Statement and Certification have also been revised. Questions regarding the contract review process may be sent by e-mail to firstname.lastname@example.org or call the NYSDOH Division of Managed Care, Bureau of Managed Care Certification and Surveillance at (518) 474-5515.
- Provider Contract Guidelines for MCOs and IPAs (PDF, 117KB, 22pg.)
- Standard Clauses for Managed Care Provider/IPA Contracts (PDF, 198KB)
- Provider Contract Statement and Certification (DOH-4255) (PDF, 277KB, 5pg.)
- Disclosure of Lobbying Activities (PDF, 61KB, 2pg.)
- Certification Regarding Lobbying (PDF, 77KB, 1pg.)
- Requests for the Provider Contract Statement and Certification in an alternate format should be made by sending an e-mail note to: email@example.com