New York State Health Care Reform Act (HCRA)

Notice to Payors, TPA's and Providers Regarding Changes to HCRA Forms

In conjunction with the redesign of our HCRA website, we have updated our election and status change forms and instructions for payors, TPA's and providers.

Please note that the individual forms that were required to be filled out by payors and TPA's to elect to make payments directly to the Public Goods Pool have now been consolidated into one packet for payors and one packet for TPA's.

In addition, due to recently established Department guidelines, former Attachment numbers (i.e. Attachment 2, 2.1, etc...) and form numbers have been retired and new form names and numbers have been established. Further, each form now has its own set of instructions.

To familiarize you with the new form numbers and names, a crosswalk has been created and can be accessed at