Department of Health

Monitoring the Quality of Medicaid Managed Care

Many of New York's Medicaid recipients are enrolled in managed care programs, and many more will be enrolled in such programs through mandatory enrollment. We examined the procedures used by the Department of Health to monitor the quality of the care provided to Medicaid recipients in managed care programs. We found the Department has taken various actions to monitor the quality of this care. However, these actions are not adequately documented by the Department and are not comprehensive enough to determine whether the care complies with all relevant regulations. We also found that complaints from patients are not always resolved in a timely manner. We make a number of recommendations aimed at strengthening the Department's monitoring efforts.

For a complete copy of Report 96-S-70 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.