New York State Medicaid managed care organizations

E377748

Medicaid managed care organization health plan managed care plan

New York State Medicaid managed care organizations are health plans that contract with the state to provide coordinated, comprehensive medical services to Medicaid enrollees under a managed care model.

Try in SPARQL Jump to: Surface forms Disambiguation Statements Elicitation Referenced by

All labels observed (1)

Label	Occurrences
New York State Medicaid managed care organizations canonical	1

How this entity was disambiguated

This entity first appeared as the object of triple T3656919 — resolving that mention is where its identity was fixed. The disambiguator weighed these candidate entities and picked the highlighted one (or “None”, minting a new entity). This is how homonymy is resolved: the same surface form can point to different entities.

NED1 Entity disambiguation (via context triple) gpt-5-mini-2025-08-07

Target entity: New York State Medicaid managed care organizations
Context triple: [Office of Health Insurance Programs, oversees, New York State Medicaid managed care organizations]

A. Medicaid
Medicaid is a U.S. government health insurance program that provides medical coverage to low-income individuals and families, jointly funded by federal and state governments.
B. Center for Medicare and Medicaid Innovation
The Center for Medicare and Medicaid Innovation is a federal agency within CMS that tests and implements new payment and service delivery models to improve quality and reduce costs in Medicare, Medicaid, and CHIP.
C. Area Agencies on Aging in New York State
Area Agencies on Aging in New York State are local organizations that plan, coordinate, and provide services and supports to help older adults live independently and maintain their quality of life in communities across the state.
D. Medicare secondary payer rules
Medicare secondary payer rules are federal regulations that determine when Medicare pays after another insurer (like employer group health plans, liability, no-fault, or workers’ compensation insurance) has primary responsibility for a beneficiary’s medical costs.
E. New York State Office of Mental Health
The New York State Office of Mental Health is a state agency responsible for overseeing, coordinating, and providing public mental health services and policy across New York.
F. None of above. chosen
G. Unsure - the case is ambiguous/there is not enough information to decide.

NED2 Entity disambiguation (via description) gpt-5-mini-2025-08-07

Target entity: New York State Medicaid managed care organizations
Target entity description: New York State Medicaid managed care organizations are health plans that contract with the state to provide coordinated, comprehensive medical services to Medicaid enrollees under a managed care model.

A. Medicaid
Medicaid is a U.S. government health insurance program that provides medical coverage to low-income individuals and families, jointly funded by federal and state governments.
B. Center for Medicare and Medicaid Innovation
The Center for Medicare and Medicaid Innovation is a federal agency within CMS that tests and implements new payment and service delivery models to improve quality and reduce costs in Medicare, Medicaid, and CHIP.
C. Area Agencies on Aging in New York State
Area Agencies on Aging in New York State are local organizations that plan, coordinate, and provide services and supports to help older adults live independently and maintain their quality of life in communities across the state.
D. Medicare secondary payer rules
Medicare secondary payer rules are federal regulations that determine when Medicare pays after another insurer (like employer group health plans, liability, no-fault, or workers’ compensation insurance) has primary responsibility for a beneficiary’s medical costs.
E. New York State Office of Mental Health
The New York State Office of Mental Health is a state agency responsible for overseeing, coordinating, and providing public mental health services and policy across New York.
F. None of above. chosen

Statements (48)

Predicate	Object
instanceOf	Medicaid managed care organization ⓘ health plan ⓘ managed care plan ⓘ
aimsTo	control Medicaid program costs ⓘ improve access to care for Medicaid members ⓘ improve quality of care for Medicaid members ⓘ
fundedBy	New York State Medicaid program ⓘ linked to: New York State Department of Health United States federal Medicaid program ⓘ linked to: Medicaid
hasContractWith	New York State Department of Health ⓘ
hasEnrollmentProcess	state-supervised Medicaid plan selection ⓘ
hasFeature	care coordination for high-need members ⓘ grievance and appeal processes for members ⓘ quality measurement and reporting ⓘ
hasPurpose	to manage cost and quality of Medicaid services ⓘ to provide comprehensive medical services to Medicaid enrollees ⓘ to provide coordinated medical services to Medicaid enrollees ⓘ
includesProgramType	Fully Integrated Duals Advantage plan ⓘ HIV Special Needs Plan ⓘ Health and Recovery Plan ⓘ Mainstream Medicaid Managed Care ⓘ Managed Long Term Care plan ⓘ Programs of All-Inclusive Care for the Elderly ⓘ
monitoredBy	New York State Department of Health Office of Health Insurance Programs ⓘ linked to: Office of Health Insurance Programs
mustComplyWith	New York State Medicaid managed care quality assurance requirements ⓘ member rights and protections requirements ⓘ network adequacy standards ⓘ
offersTo	children enrolled in Medicaid ⓘ eligible low-income adults ⓘ older adults enrolled in Medicaid ⓘ people with disabilities enrolled in Medicaid ⓘ
operatesInJurisdiction	New York State ⓘ
providesService	behavioral health services ⓘ hospital services ⓘ long-term services and supports ⓘ pharmacy benefits ⓘ preventive care services ⓘ primary care services ⓘ specialty care services ⓘ
providesServiceFor	Medicaid enrollees in New York State ⓘ
regulatesBy	New York State Department of Health ⓘ
requires	care management ⓘ provider network ⓘ utilization management ⓘ
subjectTo	New York State Medicaid managed care model contract ⓘ federal Medicaid managed care regulations ⓘ
usesModel	managed care model ⓘ
usesPaymentModel	capitation ⓘ value-based payment arrangements ⓘ

How these facts were elicited

Referenced by (1)

Full triples — surface form annotated when it differs from this entity's canonical label.

Office of Health Insurance Programs → oversees → New York State Medicaid managed care organizations ⓘ

All labels observed (1)

How this entity was disambiguated Show

Statements (48)

How these facts were elicited Show

Referenced by (1)

How this entity was disambiguated

How these facts were elicited