New York Public Health Law Article 44 - HEALTH MAINTENANCE ORGANIZATIONS
- 4400 - Statement of Policy and Purposes.
Encouraging the expansion of health care services options available to the citizens of the state is a matter of vital state concern. Without such an...
- 4401 - Definitions.
For the purpose of this article: 1. "Health maintenance organization" or "organization" means any person, natural or corporate, or any groups of such persons who...
- 4402 - Health Maintenance Organizations; Application for Certificate of Authority.
1. No person or groups of persons may operate a health maintenance organization or issue a contract to an enrollee for membership in a comprehensive...
- 4403 - Health Maintenance Organizations; Issuance of Certificate of Authority.
1. The commissioner shall not issue a certificate of authority to an applicant therefor unless the applicant demonstrates that: (a) it has defined a proposed...
- 4403-a - Special Purpose Certificate of Authority.
* 1. The commissioner may issue a special purpose certificate of authority to a provider, applying on forms prescribed by the commissioner, seeking to offer...
- 4403-b - Development of Comprehensive Health Services Plans.
* The commissioner is authorized, after consultation with the commissioner of social services, and subject to the approval of the director of the budget, to...
- 4403-c - Comprehensive Hiv Special Needs Plan Certification.
* 1. No person or group of persons may operate a comprehensive HIV special needs plan without first obtaining a certificate of authority from the...
- 4403-d - Special Needs Managed Care Plans.
No person, group of persons, county or counties may operate a special needs managed care plan without first obtaining a certificate of authority from the...
- 4403-e - Primary Care Partial Capitation Providers; Partial Capitation Certificate of Authority.
* 1. The commissioner may issue partial capitation certificates of authority to qualified individual medical services providers, counties or entities comprised of medical services providers,...
- 4403-f - Managed Long Term Care Plans.
* 1. Definitions. As used in this section: (a) "Managed long term care plan" means an entity that has received a certificate of authority pursuant...
- 4403-g - Developmental Disabilty Individual Support and Care Coordination Organizations.
* 4403-g. Developmental disability individual support and care coordination organizations. 1. Definitions. As used in this section: (a) "Developmental disability individual support and care coordination...
- 4404 - Health Maintenance Organizations; Continuance of Certificate of Authority.
1. Continuance by the commissioner of a certificate of authority issued under section forty-four hundred three of this article shall be contingent upon satisfactory performance...
- 4405 - Health Maintenance Organizations; Powers.
The powers of health maintenance organizations, in addition to any other powers conferred by the laws under which such organization is constructed, shall include: 1....
- 4405-a - Immunizations Against Poliomyelitis, Mumps, Measles, Diphtheria and Rubella.
1. It shall be the duty of the administrative officer or other person in charge of each health maintenance organization, as defined in this article,...
- 4405-b - Duty to Report.
1. (a) A health maintenance organization licensed pursuant to article forty-three of the insurance law or certified pursuant to this chapter shall make a report...
- 4406 - Health Maintenance Organizations; Regulation of Contracts.
1. The contract between a health maintenance organization and an enrollee shall be subject to regulation by the superintendent as if it were a health...
- 4406-a - Arbitration Provisions of Health Maintenance Organization Contracts.
1. The enrollee contract of a health maintenance organization may permit enrollees and adult members of the enrollee's family who are covered by such contract...
- 4406-b - Primary and Preventive Obstetric and Gynecologic Care.
1. The health maintenance organization shall not limit a female enrollee's direct access to primary and preventive obstetric and gynecologic services, including annual examinations, care...
- 4406-c - Prohibitions.
1. For purposes of this section, "health care plan" shall mean a health maintenance organization licensed pursuant to article forty-three of the insurance law or...
- 4406-d - Health Care Professional Applications and Terminations.
1. (a) A health care plan shall, upon request, make available and disclose to health care professionals written application procedures and minimum qualification requirements which...
- 4406-e - Access to End of Life Care.
1. For the purposes of this section, "health care plan" means a health maintenance organization licensed pursuant to article forty-three of the insurance law or...
- 4406-f - Maternal Depression Screenings.
To the extent a plan provides coverage for maternal depression screening, no health maintenance organization subject to this article shall by contract, written policy or...
- 4406-g - Telehealth Delivery of Services.
1. A health maintenance organization shall not exclude from coverage a service that is otherwise covered under an enrollee contract of a health maintenance organization...
- 4407 - Health Maintenance Organizations; Employer Requirements.
1. All employers subject to the provisions of the unemployment insurance law, except for those employers with fewer than twenty-five employees, shall include in any...
- 4408 - Disclosure of Information.
1. Each subscriber, and upon request each prospective subscriber prior to enrollment, shall be supplied with written disclosure information which may be incorporated into the...
- 4408-a - Integrated Delivery Systems.
* 1. Legislative purpose and findings. The legislature intends to facilitate the ability of integrated delivery systems to assume a larger role in delivering a...
- 4408-a*2 - Grievance Procedure.
* 4408-a. Grievance procedure. 1. A health maintenance organization licensed pursuant to article forty-three of the insurance law or certified pursuant to this article, and...
- 4409 - Health Maintenance Organizations; Examinations.
1. In order to carry out the provisions of this article, the commissioner, pursuant to his authority under section two hundred six of this chapter,...
- 4410 - Health Maintenance Organizations; Professional Services.
1. The provision of comprehensive health services directly or indirectly, by a health maintenance organization through its comprehensive health services plan shall not be considered...
- 4411 - Construction.
The provisions of laws other than this article shall not be applicable to the certification of any health maintenance organization under this article except where...
- 4412 - Separability.
If any clause, sentence, paragraph, subdivision, section or part of this article shall be adjudged by any court of competent jurisdiction to be invalid, the...
- 4413 - Savings Clause.
Nothing contained in this article or any act amendatory thereof shall affect or impair the validity of any act done or right accruing, accrued or...
- 4414 - Health Care Compliance Programs.
The commissioner of health, after consultation with the superintendent of financial services, shall by regulation establish standards and criteria for compliance programs to be implemented...
Last modified: February 3, 2019