HCA presents your “Admission to HCA Membership 2016!” We’ve simplified the process for you to preserve your membership this year electronically. Simply complete the form below with your contact information. Then select the appropriate dues category based on your agency’s total revenue. If you have any questions about this process, contact Laura Constable at (518) 810-0660 or lconstable@hcanys.org.

* 1. Agency Information

* 2. Dues Calculation

HCA Provider Dues are based on the agency's total patient care revenue, including all affiliate entities. The member (parent) agency must add the revenue of ALL affiliates including but not limited to CHHA, LTHHCP, LHCSA, MLTC/MCO/PACE, Telehealth/Case Management, Hospice and other. Please select the following revenue level and corresponding dues category.

* 3. Dues Payment Information

* 4. Terms and Conditions
By checking this box I acknowledge that this membership renewal application and associated dues are for the membership year that runs from January 1, 2016 through December 31, 2016. I also verify that the information contained herein is true and correct, and that the applicant meets the eligibility requirements for the membership category for which it has applied.

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