Skip to Main Content
Navigation menu

Office of Mental Health

Behavioral Health Claims Denial and Government Rate Compliance Focused Surveys

Behavioral health claims denial and government rate compliance citations, accepted corrective actions, and stipulations and orders:

  1. Affinity
    1. 2019
      1. Affinity BH Claims Denial SOD-SOF - Round 1
    2. 2021
      1. Affinity BH Claims Denial SOD-SOF - Round 2
    3. 2023
      1. Affinity Intermediate Sanction
  2. Amida Care
    1. 2019
      1. Amida Care BH Claims Denial SOD-SOF - Round 1
    2. 2021
      1. Amida Care BH Claims Denial SOD-SOF - Round 2
    3. 2022
      1. Amida Care Intermediate Sanction
    4. 2024
      1. Amida Care BH Government Rate Compliance Survey
  3. EmblemHealth
    1. 2019
      1. EmblemHealth BH Claims SOD-SOF - Round 1
    2. 2021
      1. EmblemHealth BH Claims SOD-SOF - Round 2
    3. 2023
      1. EmblemHealth Intermediate Sanction
    4. 2024
      1. Emblem Health BH Government Rate Compliance Survey
  4. HealthPlus
    1. 2024
      1. HealthPlus BH Government Rate Compliance Survey
  5. IHA
    1. 2019
      1. IHA BH Claims Denial SOD-SOF - Round 1
    2. 2021
      1. IHA BH Claims Denial SOD-SOF - Round 2
  6. MetroPlus
    1. 2019
      1. MetroPlus BH Claims Denial SOD-SOF - Round 1
    2. 2021
      1. MetroPlus BH Claims Denial SOD-SOF - Round 2
    3. 2022
      1. MetroPlus Intermediate Sanction
  7. MVP
    1. 2019
      1. MVP BH Claims Denial SOD-SOF - Round 1
    2. 2021
      1. MVP BH Claims Denial SOD-SOF - Round 2
    3. 2022
      1. MVP Intermediate Sanction

For more information regarding citations, please visit the Citations and Regulatory Actions webpage.

For questions regarding citations, please contact the BHO Mailbox.

Please contact OMH Managed Care with any questions, comments, or problems you may be experiencing with this site. If you would like to file a complaint about behavioral health managed care, please visit the Information on Filing a Complaint page. Providers, if you have any questions about the managed care implementation, please complete and send a question form.

Office of Mental Health

About OMH

Contact Us

Help

Resources