Already in the five boroughs of New York City, and coming very soon in Suffolk and Nassau Counties, Medicaid recipients are having to get used to the idea of selecting a managed care provider.
Prior to the managed care system going into effect, Medicaid recipients were at liberty to choose any primary care physicians, specialists, pharmacists and nursing homes they desired. In short, under the old regime, Medicaid recipients had the unfettered freedom to choose among doctors accepting Medicaid. With managed care, however, this freedom will begin to erode.
Under the new regime of managed care, Medicaid recipients will be required to choose between a select few managed care providers. Once a managed care provider is selected, the recipient will be required to see only those medical service providers in the network of their managed care providers, as each provider is a health maintenance organization (“HMO”). Understanding which network the recipient’s doctors, pharmacists and nursing homes are in will be crucial in selecting the best managed care provider.