EXHIBIT 10.56

                                 GENERAL RELEASE
                                 By and Between
                      VYTRA HEALTH PLANS LONG ISLAND, INC.
                                       AND
                   NATIONAL MEDICAL HEALTH CARD SYSTEMS, INC.


     This is a General Release made and entered into by and between Vytra Health
Plans Long Island,  Inc.,  Vytra Health  Services,  Inc., and Vytra Health Plans
Managed  Systems,  Inc., with a principal place of business at 395 North Service
Road, Melville,  New York 11747 and National Medical Health Card Systems,  Inc.,
with a place of business at 26 Harbor Park  Drive,  Port  Washington,  New York,
11050.

     WHEREAS, Vytra Health Plans Long Island, Inc., Vytra Health Services, Inc.,
and Vytra  Health Plans  Managed  Systems,  Inc.  ("Vytra"),  formerly  known as
ChoiceCare Long Island,  Inc.,  entered into an agreement with National  Medical
Health Card Systems, Inc. ("Health Card") dated April 15, 1996 (the "Agreement")
whereby Health Card agreed to, among other things,  provide pharmacy services to
Vytra's members in exchange for payments to be made by Vytra to Health Card; and

     WHEREAS,  the  parties  wish to  settle  and  resolve  forever  any and all
obligations  on the part of Vytra to make  payments  to  Health  Card  under the
Agreement for the period from January 1, 1999 through and including December 31,
1999,  and the parties  hereto  specifically  acknowledge  and agree that Health
Card's  obligation to refund to Vytra rebates accruing under the Agreement shall
remain unaffected by this General Release.

     NOW, THEREFORE,  in consideration of the mutual promises and considerations
to be paid,  the parties  thereto  agree and covenant to enter into this General
Release to the following terms and conditions:

     1. To resolve  and settle  forever any and all  payments  due from Vytra to
Health Card under the  Agreement for the period from January 1, 1999 through and
including  December 31, 1999,  Health Card agrees to accept all payments made to
date by Vytra,  and that said  payments  settle and resolve  forever any and all
financial  obligations  of Vytra  under the  Agreement  for dates of  service or
prescriptions  filled from  January 1, 1999 through and  including  December 31,
1999;

     2.  It  is  specifically  and  unambiguously   agreed  that  Health  Card's
obligation to refund to Vytra any and all rebates it is contractually  obligated
to refund under the Agreement  remains  unaffected by this General Release,  and
Health Card's  obligation to pay Vytra any and all rebates and refunds under the
Agreement whatsoever shall survive execution hereof; and

     3.  This  General  Release  shall  not  apply  in the  case  of  fraudulent
misrepresentation by a party.

     IN WITNESS  HEREOF,  the parties  have caused  this  General  Release to be
executed by their duly  authorized  representatives  on the 1st day of December,
2000.

Vytra Health Plans Long Island,Inc.    National Medical Health Card Systems,Inc.
Vytra Health Services, Inc.
Vytra Health Plans Managed Systems,Inc.


By: /s/ Philip Gandolfo                 By:  /s/ Bert E. Brodsky
   Philip Gandolfo                         Bert E. Brodsky
   Executive Vice President/CFO            Chairman of the Board