N.Y. MHY Law § 32.06 — New York Code / Act MHY / Title E / Article 32 / Section 32.06
Prohibited practices by providers of substance use disorder services
Status: in_force

§ 32.06 Prohibited practices by providers of substance use disorder\n          services.\n  1. For purposes of this section, unless the context clearly requires\notherwise, "provider" shall mean any person, firm, partnership, group,\npractice association, fiduciary, employer, representative thereof or any\nother entity who is providing or purporting to provide substance use\ndisorder services or operating or purporting to operate a certified\nrecovery residence. Provided, however, that "provider" shall not include\na person receiving substance use disorder services from the provider.\n  2. No provider shall intentionally solicit, receive, accept or agree\nto receive or accept any payment, benefit or other consideration in any\nform to the extent such payment, benefit or other consideration is given\nfor the referral of a person as a potential patient for substance use\ndisorder services or as a resident at a certified recovery residence.\n  3. No provider providing or purporting to provide substance use\ndisorder services or operating or purporting to operate a certified\nrecovery residence pursuant to this chapter, shall intentionally make,\noffer, give, or agree to make, offer, or give any payment, benefit or\nother consideration in any form to the extent such payment, benefit or\nother consideration is given for the referral of a person as a potential\npatient for substance use disorder services.\n  4. This section shall not apply to any:\n  (a) lawful payments by a health maintenance organization or health\ninsurer, operating in accordance with article thirty-two or forty-three\nof the insurance law or article forty-four of the public health law on\nbehalf of their enrollees for such substance use disorder services or\nother benefits required to be provided;\n  (b) lawful payments to or by a provider to a health maintenance\norganization or health insurer operating in accordance with article\nthirty-two or forty-three of the insurance law or article forty-four of\nthe public health law, as payment for services provided, a refund for an\noverpayment, a participating provider fee, or any similar remuneration;\n  (c) provider for an activity that, at the time of such activity, would\nhave been lawful as specifically exempt, or otherwise not prohibited,\nunder any federal statute or regulations, including but not limited to\n42 U.S.C. § 1320a-7b (b) or the regulations promulgated thereunder, if\nconducted by a person, firm, partnership, group, practice, association,\nfiduciary, employer representative thereof or any other entity providing\nsubstance use disorder services;\n  (d) any employee or representative of a provider who is conducting\nmarketing activities, where the employee or representative identifies\nthe provider represented or for whom or which the employee or\nrepresentative works, identifies that the employee or representative is\na marketer and not a clinician or other individual who can provide\ndiagnostic, counseling or assessment services, and such marketing\nactivities are limited to educating the potential patient about the\nprogram with no effort to steer or lead the potential patient to select\nor consider selection of the substance use disorder services provider\nrepresented or for whom or which the employee or representative works;\nor\n  (e) commissions, fees or other remuneration lawfully paid to insurance\nagents as provided under the insurance law.\n  5. Any provider who intentionally violates the provisions of\nsubdivision two or three of this section shall be guilty of a\nmisdemeanor as defined in the penal law.\n  6. If the commissioner has reason to believe a provider has violated\nsubdivision two or three of this section, the commissioner may proceed\nto investigate and institute enforcement actions, as may be authorized\npursuant to the applicable provisions of this article.\n  7. The provisions of this section are in addition to any other civil,\nadministrative or criminal enforcement actions provided by law.\nPenalties authorized under this section may be imposed against corporate\nproviders and individual providers.\n  8. The commissioner shall adopt and may amend rules and regulations to\neffectuate the provisions of this section.\n