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This Office of Health Insurance Programs Administrative Directive (OHIP/ADM) advises social services districts of amendments to the Department's regulations at 18 NYCRR §360-7.5(a), which govern the circumstances in which direct reimbursement of paid medical bills may be made to eligible Medicaid or Family Health Plus recipients or their representatives. As amended, these regulations reflect several federal and State court decisions: the federal district court orders in Greenstein v. Dowling (1994) and Carroll v. DeBuono (1998) and the New York State Court of Appeals decision in Seittelman v. Sabol (1998). At the time of these court decisions, the Department issued several General Information System (GIS) messages that instructed social services districts regarding how they must implement the decisions. Social services districts should now consult the instructions that are contained in this directive. It consolidates the Department's prior GIS messages, and explains the amendments to 18 NYCRR §360-7.5(a).
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