S T A T E O F N E W Y O R K
________________________________________________________________________
7484
2009-2010 Regular Sessions
I N A S S E M B L Y
April 13, 2009
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Introduced by M. of A. BALL, CALHOUN -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to health care retainer
programs
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 1108 of the insurance law is amended by adding a
2 new subsection (j) to read as follows:
3 (J) EVERY HEALTH CARE RETAINER PROGRAM OPERATED PURSUANT TO ARTICLE
4 FIFTY-SEVEN OF THIS CHAPTER.
5 S 2. The insurance law is amended by adding a new article 57 to read
6 as follows:
7 ARTICLE 57
8 HEALTH CARE RETAINER PROGRAMS
9 SECTION 5701. DEFINITIONS.
10 5702. HEALTH CARE RETAINER PROGRAMS.
11 S 5701. DEFINITIONS. AS USED IN THIS ARTICLE:
12 (A) "AGREEMENT" SHALL MEAN A HEALTH CARE RETAINER AGREEMENT ENTERED
13 INTO PURSUANT TO A PROGRAM OPERATED BY A PRIMARY CARE PHYSICIAN OR
14 PRIMARY CARE PHYSICIANS.
15 (B) "PRIMARY CARE" SHALL MEAN PROFESSIONAL MEDICAL CARE OFFERED IN THE
16 FIELDS OF FAMILY PRACTICE, GENERAL PEDIATRICS, PRIMARY CARE INTERNAL
17 MEDICINE, AND PRIMARY CARE OBSTETRICS AND GYNECOLOGY, AND AS DEFINED IN
18 THE RULES AND REGULATIONS OF THE COMMISSIONER OF HEALTH.
19 (C) "PRIMARY CARE PHYSICIAN" SHALL MEAN A PERSON LICENSED TO PRACTICE
20 MEDICINE IN THIS STATE WHOSE PRIMARY FIELD OF PRACTICE IS PRIMARY CARE.
21 (D) "PRIMARY CARE PRACTITIONER" SHALL MEAN A MIDWIFE, NURSE PRACTI-
22 TIONER OR PHYSICIAN ASSISTANT AUTHORIZED TO PRACTICE IN THIS STATE, WHO
23 PROVIDES PRIMARY CARE, AND WHO IS SUBJECT TO THE SUPERVISION AND DIREC-
24 TION OF A PRIMARY CARE PHYSICIAN.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10853-01-9
A. 7484 2
1 (E) "PROGRAM" SHALL MEAN A HEALTH CARE RETAINER PROGRAM OFFERED AND
2 OPERATED BY A PRIMARY CARE PHYSICIAN OR A GROUP OF PRIMARY CARE PHYSI-
3 CIANS WHEREBY SUCH PHYSICIAN OR PHYSICIANS, AND PRIMARY CARE PRACTITION-
4 ERS UNDER THE CONTROL OF SUCH PHYSICIAN OR PHYSICIANS, AGREE TO PROVIDE
5 ALL NECESSARY PRIMARY CARE TO ANY PERSON ENTERING INTO AN AGREEMENT, AND
6 THEIR DEPENDENTS, FOR A CERTAIN PERIOD OF TIME IN EXCHANGE FOR A FEE
7 ESTABLISHED UPON ENTERING INTO THE AGREEMENT.
8 S 5702. HEALTH CARE RETAINER PROGRAMS. ANY PRIMARY CARE PHYSICIAN OR
9 GROUP OF PRIMARY CARE PHYSICIANS MAY ESTABLISH AND OPERATE A HEALTH CARE
10 RETAINER PROGRAM SUBJECT TO THE PROVISIONS OF THIS SECTION.
11 (A) EVERY AGREEMENT SHALL BE WRITTEN IN CLEAR, CONCISE AND EASY TO
12 UNDERSTAND LANGUAGE, AND FULLY DEFINE THE PRIMARY CARE SERVICES COVERED
13 BY SUCH AGREEMENT, THE FEE FOR THE PROVISION OF SUCH SERVICES, AND THE
14 PERIOD OF TIME SUCH SERVICES ARE TO BE PROVIDED FOR SUCH FEE.
15 (B) EVERY AGREEMENT SHALL BE LIMITED TO THE PROVISION OF PRIMARY CARE.
16 (C) ALL FEES AND CHARGES PAID FOR AGREEMENTS SHALL BE DEPOSITED BY THE
17 OPERATORS OF A PROGRAM IN AN UNSEGREGATED INTEREST-BEARING DEPOSIT
18 ACCOUNT WITH A BANKING INSTITUTION, AS DEFINED IN THE BANKING LAW.
19 MONEYS SHALL BE PAID OUT OF SUCH ACCOUNT ONLY IN SUCH AMOUNT AS IS
20 EQUIVALENT TO THE FEES AND CHARGES FOR PRIMARY CARE DELIVERED DURING THE
21 PRECEDING CALENDAR MONTH.
22 (D) EVERY PROGRAM SHALL, ON OR BEFORE FEBRUARY FIRST EACH YEAR, SUBMIT
23 AN AFFIDAVIT TO THE SUPERINTENDENT ATTESTING TO ITS COMPLIANCE WITH THE
24 PROVISIONS OF THIS ARTICLE DURING THE IMMEDIATELY PRECEDING CALENDAR
25 YEAR.
26 S 3. This act shall take effect immediately.