NY Medicaid Enrollment vs. MMC and HARP Credentialing
By George Ruan • October 9, 2026
Use the official NYSDOH managed-care plan directory to identify New York Medicaid Managed Care and Health and Recovery Plan (HARP) options. Then separate two requirements: state Medicaid provider enrollment through eMedNY and network participation with the specific plan. A Medicaid ID alone does not establish an in-network effective date. This guide was checked October 9, 2026.
Sections
State enrollment and plan participation are separate
The eMedNY managed-care network provider page explains the state enrollment requirement for Medicaid managed-care network providers. Its provider-listing guidance distinguishes FFS enrollment from managed-care and OPRA enrollment; the latter two do not permit FFS billing. An application that is pending is not an active enrollment.
Start with the profession-specific enrollment steps. Separately, work with each plan on credentialing, contracting and roster activation for the Medicaid or HARP product you intend to serve. Do not rely on a commercial-network approval as evidence of Medicaid participation.
Current New York Medicaid Managed Care and HARP plans
The official directory's September 2026 revision, checked October 9, 2026 through NYSDOH's alternate official address, lists the following 12 legal entities with both Medicaid and HARP availability in at least one county:
Capital District Physician's Health Plan, Inc.
Excellus Health Plan, Inc.
Health Insurance Plan of Greater New York, Inc.
Healthfirst PHSP, Inc.
Highmark Western and Northeastern New York Inc.
Anthem HP, LLC.
Independent Health Association, Inc.
MetroPlus Health Plan, Inc.
Molina Healthcare of New York, Inc.
MVP Health Plan, Inc.
New York Quality Healthcare Corporation
United Healthcare of New York, Inc.
These are the directory's legal names. Its Medicaid entries also include three Special Needs Plan entries: Amida Care, Inc. (SNP), MetroPlus Health Plan, Inc. (SNP), and VNS Choice SNP. Those entries are not labeled HARP in this directory.
Read the live official list by county and program before selecting a plan. This snapshot does not mean every listed entity offers every product statewide or is accepting new clinicians. The directory includes other insurance products, so the presence of a company name alone does not identify a Medicaid option. Healthfirst PHSP and Healthfirst Health Plan are separate entries; Anthem HP and Anthem HealthChoice HMO are also separate entries.
What to confirm with the plan
The state directory identifies plan availability; it is not your participation record. We recommend asking each plan to confirm these items in writing:
The exact Medicaid, HARP or SNP product and network for which the provider is approved.
The individual rendering NPI, billing/group NPI, tax entity and service locations included in the participation record.
Whether credentialing, contracting and roster loading are complete, and the effective date for each applicable provider/location.
The plan's behavioral health authorization, electronic claims and telehealth instructions for that product.
Keep a separate tracker for state enrollment and each plan. A state approval notice resolves the enrollment question; the plan's own participation confirmation resolves the network question. A directory listing for the practice should be checked against the approved provider and location rather than treated as a substitute for that confirmation.
Route each member using current eligibility
Use ePACES/MEVS eligibility for the service date. The response guide shows managed-care information and coverage details. Confirm who covers the intended behavioral health service and follow that payer's authorization and claims rules.
For a covered managed-care service, use the plan's submission instructions. For an appropriate FFS service, use the eMedNY claims workflow. When telehealth is involved, compare the state guidance and the plan's requirements. Plan selection, provider enrollment and a member's current coverage must all line up for the actual visit.
Frequently Asked Questions
Does New York Medicaid enrollment make me in-network with every HARP?
No. State enrollment and participation in a specific managed-care or HARP network are separate. Obtain the plan’s confirmation of product, provider, location and effective date.
Where is the current official New York Medicaid plan list?
NYSDOH publishes a managed-care directory by plan showing program and county availability. This article uses its September 2026 revision checked October 9, 2026; consult the live directory for changes.
Can a managed-care-only enrollment bill Medicaid FFS?
The eMedNY network-provider guidance distinguishes managed-care enrollment from FFS enrollment and says managed-care and OPRA enrollments do not permit FFS billing.
Sources
Need help getting payer-ready?
For practices enrolled in Bomi Billing, our team handles CAQH, payer applications, attestations, roster updates, and ongoing credentialing. Credentialing requires Bomi Billing.
Credentialing with billing
About Bomi
Founded by George Ruan, Dax Earl, and Andrey Goder, Bomi helps independent therapists and group practices with insurance billing, credentialing, and payer follow-up. Bomi grew out of Dax’s experience helping his mother with her therapy practice, with a clear purpose: reduce the administrative burden of insurance while keeping practice owners in control.
Meet our founders