Information for Recipients in the Recipient Restriction Program (RRP)

Information

It is important to remember that the primary care provider, whether a physician, nurse practitioner, or clinic, is responsible for providing most of your health care needs. A referral will be required from your primary care provider for any non-emergency medical services rendered by a specialty provider, including the ordering of transportation.

Your primary pharmacy is responsible for managing the delivery of your medications.

It is your responsibility, as the restricted recipient, to initiate a relationship with your primary health care provider and/or pharmacy.  A change of medical provider or pharmacy can be requested every three months, or at an earlier time for good cause. Please see below for instructions and who to contact to change your provider(s).

TO CHANGE YOUR ASSIGNED PRIMARY MEDICAL PROVIDER OR CLINIC

For Medicaid Fee-for Service (FFS) upstate recipients (All counties outside of New York City)

For NYC Medicaid FFS recipients:

  • Contact the New York City Human Resources Administration (HRA): 888-692-6116

For Medicaid Managed Care recipients (Upstate and New York City)

  • Contact your Managed Care Plan
TO CHANGE YOUR ASSIGNED PHARMACY

For upstate recipients (All counties outside of New York City):

For New York City recipients:

  • Contact HRA: 888-692-6116

Coverage obtained through the NY State of Health (NYSoH):

  • Contact NYSoH: 855-355-5777
RECIPIENT RIGHTS

You have the right to request a conference and/or request a Fair Hearing to appeal the restriction decision.

RIGHT TO A CONFERENCE: 

You may request a conference to review the restriction decision. If you decide to request a conference, you should ask for one as soon as possible.  You can present information that indicates a wrong decision was made at the conference, and the decision may be reversed if appropriate. If you ask for a conference, you are still entitled to a fair hearing.  If you want to have your benefits continue unchanged (aid continuing) until your fair hearing, you must request a fair hearing within sixty (60) days of receiving your notice. A request for a conference alone will not result in continuation of benefits. 

RIGHT TO A FAIR HEARING: 

You can request a fair hearing in writing, by telephone, in person, or online.

In writing:   Send a copy of your restriction notice and the Fair Hearing request (completed), to:

Office of Administrative Hearings
New York State Office of Temporary and Disability Assistance
P.O. Box 1930
Albany, New York 12201 

Please keep a copy for yourself.

By telephone:  (800) 342-3334 (Please have your restriction notice available when you call)     

By fax:  FAX a copy of your restriction notice and the Fair Hearing request (completed) to: (518) 473-6735

Online:   Complete and send the online request form at: https://otda.ny.gov/hearings/request/#online

For questions concerning the Recipient Restriction Program, calls can be directed to the OMIG RRP helpline at: 518-474-6866 or email: [email protected].

Frequently Asked Questions (FAQs)