Member’s Rights & Responsibilities

Please refer to the Empire member handbook for more information about:

  • A member’s right to fair treatment
  • Empire Privacy Practices
  • Your responsibility to report waste, fraud and abuse
  • Your right to appeal health care problems
  • Your right to a fair hearing

The member, their parents and any representatives they choose have the right to:

  • Be treated with respect, dignity, privacy, and fairness
  • Be involved in their medical or behavioral health decisions and care plan
  • Be told in an understandable way about the necessary treatment options for their conditions, no matter what they cost or if the benefit is covered
  • Choose and/or change health care providers
  • Make a complaint about Empire or appeal any decisions regarding the care or services we provide
  • Get information about Empire, its services, doctors and other providers
  • Get information about their member rights and responsibilities
  • Make suggestions to us regarding Empire rights and responsibilities policy

They have the responsibility to:

  • Listen to health care advice and follow the care plan they agreed to with their doctors
  • Be sure they know what might happen if they accept or reject health care advice
  • Be sure they understand their health problems and help plan their treatment goals
  • Provide Empire and their doctors with information needed to carry out their care and services
  • Tell Empire and their doctors if they want to leave the program

Empire is a culturally diverse company. We welcome all eligible individuals into our health care programs, regardless of health status. If you have questions or concerns, please call 1-800-300-8181 (TTY 711) and ask for extension 34925. Or visit www.empireblue.com/nymedicaid.