18 CRR-NY 513.3NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 18. DEPARTMENT OF SOCIAL SERVICES
CHAPTER II. REGULATIONS OF THE DEPARTMENT OF SOCIAL SERVICES
SUBCHAPTER E. MEDICAL CARE
ARTICLE 3. POLICIES AND STANDARDS GOVERNING PROVISION OF MEDICAL AND DENTAL CARE
PART 513. PRIOR APPROVAL OF MEDICAL, DENTAL AND REMEDIAL CARE
18 CRR-NY 513.3
18 CRR-NY 513.3
513.3 Obligations end responsibilities of recipients.
(a) The recipient is responsible for establishing that the medical, dental and remedial care, services or supplies are medically necessary to prevent, diagnose, correct or cure a medical condition and that any specific statutory or regulatory requirements for prior approval of the care, services or supplies are met.
(b) The recipient is responsible for providing all information, appropriate to the request, that the Department of Health reasonably requires to evaluate a request, including detailed health information and information concerning his or her education, training and employment, activities of daily life, and current living arrangements.
(c) The recipient must cooperate with the Department of Health in obtaining information necessary to evaluate a request. If the Department of Health determines that available information is not sufficient to enable it to make an informed determination, the recipient must submit to a clinical examination by an independent practitioner under contract with the Department of Health or by a practitioner employed or designated by the Department of Health.
18 CRR-NY 513.3
Current through July 31, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: JULY 31, 2023, is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Admisnistrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of the NYS Rules.