Matter of Stanley v. DeBuono

In Matter of Stanley v. DeBuono, 273 AD2d 169 [1st Dept 2000] the Court noted that although the term "qualified orthodontists" is not defined in the Department of Education regulations, the appropriate reference to determine who is a "qualified orthodontist" (for medicaid reimbursement purposes) is included in 18 NYCRR 504.3[i], which incorporates by reference the Medicaid Management Information System Provider Manual ("MMIS"). The MMIS then refers to 18 NYCRR 506.1(c) which provides that to qualify as a dental specialist, which includes orthodontia, the individual (1) is a diplomat of the appropriate American Board; or (2) is listed as a specialist in the American Dental Directory of the American Dental Association section on "character of practice"; or (3) is listed as a specialist on the roster of approved dental specialists of the New York State Department of Health.