Pay BillNew York State Department of Health Standard Clauses and 2015 Medicare Addendum
Please download the applicable document(s) below and attach it to your participating provider agreement(s).
Note: This document includes the Certification Regarding Lobbying form. If you have not previously signed and returned this form, please complete it and fax it to (716) 250-7176.
If you have any questions, our Provider Relations Department can be reached at (716) 631-3282 or 1-800-736-5771, Monday through Friday from 8 a.m. to 6 p.m.