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Title: Section 513.2 - Procedure for obtaining prior approval.

513.2 Procedure for obtaining prior approval. (a) When prior approval of medical, dental and remedial care is required, the potential provider must request such approval from the Department of Health using the forms and procedures prescribed by the Department of Health.

(b) The provider manuals of this department detail the forms and procedures for obtaining prior approval. The manuals are provided free of charge to every provider at the time of enrollment in the MA program. Copies of the manuals may be obtained by writing Computer Sciences Corporation, Health and Administrative Services Division, 800 N. Pearl St., Albany, NY 12204. Copies may also be obtained from the Department of Social Services, 45 N. Pearl St., Albany, NY 12243.

(c) A recipient adversely affected by the Department of Health's determination on a request may obtain a fair hearing before an impartial hearing officer employed by this department in accordance with section 513.8 of this Part and Part 358 of this Title.


VOLUME C (Title 18)