Contact the Division of Managed Care and Division of Quality and Evaluation

The New York State Department of Health, Division of Managed Care (DMC) is responsible for coordination of efforts to improve quality and regulatory oversight of managed care plans and the implementation of the mandatory Medicaid managed care program. DMC monitors health maintenance organizations (HMOs), prepaid health services plans (PHSPs), HIV Special Needs Plans (HIV/SNPs), Primary Care Partial Capitation Providers (PCPCP), Workers' Compensation preferred provider organizations (PPOs), and managed long-term care (MLTC) plans. Health Maintenance Organizations are certified jointly by the Department of Health and the New York State Department of Financial Services.

All managed care plans must meet requirements in public health law, including the 1996 Managed Care Bill of Rights. DMC acts to ensure that managed care systems promote wellness and improve health status, are accountable for quality of care, and produce measurable results. At the same time, efforts are made to ensure that managed care remains an affordable insurance option and managed care plans are fiscally sound and well-managed entities.