reglab/housing_qa huggingface dataset:
NY Pub Health L § 4406-G (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4406-G - Telehealth Delivery of Services.

§  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   because the service is delivered via telehealth, as that term is defined   in  subdivision  two  of  this section; provided, however, that a health   maintenance organization may exclude from coverage a service by a health   care provider where the provider is  not  otherwise  covered  under  the   enrollee  contract.  A  health  maintenance organization may subject the   coverage  of  a  service  delivered  via  telehealth   to   co-payments,   coinsurance  or deductibles provided that they are at least as favorable   to the enrollee as those established  for  the  same  service  when  not   delivered  via telehealth. A health maintenance organization may subject   the coverage  of  a  service  delivered  via  telehealth  to  reasonable   utilization  management  and  quality  assurance  requirements  that are   consistent  with  those  established  for  the  same  service  when  not   delivered via telehealth.2.  For  purposes  of  this  section,  "telehealth"  means  the use of   electronic information and communication technologies by a  health  care   provider  to  deliver  health  care  services  to an enrollee while such   enrollee is located at a site that is different from the site where  the   health care provider is located.
NY Pub Health L § 4409 (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4409 - Health Maintenance Organizations; Examinations.

§ 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,  shall   examine  not  less  than once every three years, each health maintenance   organization and all participating entities through  which  such  health   maintenance  organization  offers  health  services as to the quality of   health  care  services  offered,  and  the  adequacy  of  its   provider   arrangements.2.  The  superintendent  shall  examine not less than once every three   years  into  the  financial   affairs   of   each   health   maintenance   organization,   and  transmit  his  findings  to  the  commissioner.  In   connection with any such  examination,  the  superintendent  shall  have   convenient  access  at all reasonable hours to all books, records, files   and other documents relating to the affairs of such organization,  which   are  relevant  to  the  examination. The superintendent may exercise the   powers set forth in sections three hundred  four,  three  hundred  five,   three  hundred  six  and  three  hundred  ten  of  the  insurance law in   connection with such examinations, and may also require special  reports   from such health maintenance organizations as specified in section three   hundred  eight  of  the  insurance  law.  As part of an examination, the   superintendent shall review determinations of coverage for substance use   disorder treatment and shall ensure that such determinations are  issued   in  compliance  with  section  four  thousand three hundred three of the   insurance law and title one of article forty-nine of this chapter.3. The superintendent and the commissioner are authorized to share and   exchange  information  obtained  by  them  in  the  exercise  of   their   respective responsibilities under the insurance law and this chapter.4.  Nothing  contained  in this section shall be deemed to require the   public disclosure of privileged patient information.
NY Pub Health L § 4411 (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4411 - Construction.

§  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 so specified; provided,   however, that no health maintenance organization shall  include  in  its   name the words "insurer", "casualty", "health and accident" or any words   generally  regarded  as  descriptive of the insurance function; provided   further, that this provision shall not be construed as  prohibiting  the   participation in a comprehensive health services plan of any corporation   or  other  entity organized under any other law, to the extent that such   corporations or entities are authorized to participate by law, including   but  not  limited  to  the  insurance  law,  business  corporation  law,   education law, not-for-profit corporation law, or general municipal law;   nor  shall  this section be considered to prevent the application of any   other law to the entities comprising such plan.
NY Pub Health L § 4412 (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4412 - Separability.

§ 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  judgment  shall  not  affect,   impair,  or  invalidate  the remainder thereof, but shall be confined in   its operation to the clause, sentence, paragraph,  subdivision,  section   or  part  thereof  directly  involved  in  the  controversy in which the   judgment shall have been rendered.
NY Pub Health L § 4413 (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4413 - Savings Clause.

§  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 acquired or any order, judgment, or status   established  prior  to  the  enactment  of  this article or prior to the   amendment of any act amendatory thereof.Medical corporations organized pursuant to the  provisions  of  former   article  forty-four  of  the  public  health  law in effect prior to the   effectiveness of the provisions of this article may continue to  operate   pursuant  to  the provisions of law in effect prior to the effectiveness   hereof.Health maintenance organizations that  applied  for  a  license  under   article  forty-three  of  the  insurance  law and receive approval under   article twenty-eight of the public health law  may  continue  under  the   provisions  of  the  laws  in  existence  on  the effective date of this   article.
NY Pub Health L § 4414 (2021)
2021 New York Laws PBH - Public Health Article 44 - Health Maintenance Organizations 4414 - Health Care Compliance Programs.

§  4414.  Health  care compliance programs. 1. The commissioner, after   consultation with the superintendent of  financial  services,  shall  by   regulation  establish  standards and criteria for compliance programs to   be implemented by persons providing coverage  or  coverage  and  service   pursuant to any public or governmentally-sponsored or supported plan for   health  care  coverage  or  services.  Such  regulations  shall  include   provisions for the design and implementation of programs or processes to   prevent,  detect  and  address  instances  of  fraud  and  abuse.   Such   regulations  shall take into account the nature of the entity's business   and the size of  its  enrolled  population.  The  commissioner  and  the   superintendent of financial services shall accept programs and processes   implemented  pursuant  to section four hundred nine of the insurance law   as satisfying the  obligations  of  this  section  and  the  regulations   promulgated  thereunder when such programs and processes incorporate the   objectives contemplated by this section.2. Notwithstanding any provisions of section twelve of this chapter to   the  contrary,  penalties  collected   from   any   health   maintenance   organization  certified  pursuant  to  this  article  resulting  from  a   violation of the health maintenance  organization's  mental  health  and   substance use disorder parity compliance program shall be deposited into   the  behavioral health parity compliance fund as established pursuant to   section ninety-nine-hh of the state finance law.
NY Pub Health L § 4500 (2021)
2021 New York Laws PBH - Public Health Article 45 - Medical Referral Services 4500 - Legislative Findings and Statement of Policy.

§  4500. Legislative findings and statement of policy. The security of   the health and welfare of the residents of this state requires, that the   utmost attention be given to assure that persons  seeking  medical  care   and  treatment  in  this state receive adequate care rendered within the   standards of ethics and public policy applicable  to  all  practices  of   medicine.   Medical   referral  services,  organized  as  profit  making   enterprises within this state, have been found  to  be  engaged  in  the   practice of medicine, have been sharing fees received for referrals with   doctors and hospitals to whom patients are referred, have been otherwise   compensating  doctors  and  hospitals for accepting patients referred to   them, have been giving medical advice by telephone  to  persons  seeking   referrals  and have been advertising their services, all in violation of   the standards of ethics and public policy applicable to the practice  of   medicine  and  which  would  be  violations of standards of professional   conduct if the acts were performed by physicians.   Such  profit  making   referral services have consistently engaged in practices inimical to the   public interest which would be prohibited to physicians and have engaged   in  relationships with physicians which are in violation of the laws and   public policy of this state  and  which  have  permitted  physicians  to   benefit  indirectly from acts and practices which would be prohibited to   them directly.  It is hereby declared to be the public  policy  of  this   state that the public health, safety and welfare of the citizens of this   state   require   that  such  profit  making  medical  referral  service   organizations be declared to be invalid and unlawful in this state.
NY Pub Health L § 4501 (2021)
2021 New York Laws PBH - Public Health Article 45 - Medical Referral Services 4501 - Medical Referral Service Businesses Prohibited.

§  4501. Medical referral service businesses prohibited. 1. No person,   firm, partnership, association or  corporation,  or  agent  or  employee   thereof,  shall  engage  in  for profit any business or service which in   whole or in part includes the referral or recommendation of persons to a   physician, dentist, hospital, health related facility, or dispensary for   any form of medical or dental  care  or  treatment  of  any  ailment  or   physical  condition.  The  imposition  of  a  fee or charge for any such   referral or recommendation shall create a presumption that the  business   or service is engaged in for profit.2.  No  physician,  dentist,  hospital,  health  related  facility  or   dispensary shall enter into a contract or other  form  of  agreement  to   accept  for  medical  or dental care or treatment any person referred or   recommended for such care or treatment by a medical or  dental  referral   service  business  located  in or doing business in another state if the   medical or dental referral service business would  be  prohibited  under   this  section  if the business were located in or doing business in this   state.
NY Pub Health L § 4502 (2021)
2021 New York Laws PBH - Public Health Article 45 - Medical Referral Services 4502 - Penalties.

§  4502.  Penalties.  1. A violation of the provisions of this section   shall constitute a  misdemeanor  and  upon  conviction  thereof  may  be   punished  by  imprisonment for not longer than one year or a fine of not   more than five thousand dollars or by both such fine and imprisonment.2. Whenever there shall be a violation of this section, an application   also may be made by the attorney general in the name of  the  people  of   the state of New York to a court or justice having jurisdiction to issue   an  injunction,  and  upon notice to the defendant of not less than five   days, to enjoin and restrain the continuance of such violation;  and  if   it  shall  appear  to  the satisfaction of the court or justice that the   defendant has, in fact, violated this  section,  an  injunction  may  be   issued  by  such court or justice, enjoining and restraining any further   violation, without requiring proof that any person has,  in  fact,  been   injured  or  damaged  thereby. In any such proceeding the court may make   allowances  to  the  attorney  general  as  provided  in  section  8303,   subdivision  6  of  the civil practice law and rules. In connection with   any such proposed application, the attorney  general  is  authorized  to   take  proof  and make a determination of the relevant facts and to issue   subpoenas in accordance with the civil practice law and rules.
NY Pub Health L § 4503 (2021)
2021 New York Laws PBH - Public Health Article 45 - Medical Referral Services 4503 - Application.

§ 4503. Application. The provisions of this article shall not apply to   any  individual,  agency,  association  or  corporation not organized or   incorporated  for  pecuniary  profit  or  financial  gain  or   to   any   organization  or  association  which is exempt from taxation pursuant to   section 501 (c) of title 26 of the United States Code, constituting  the   Internal Revenue Code of l954, as amended.
NY Pub Health L § 4600 (2021)
2021 New York Laws PBH - Public Health Article 46 - Continuing Care Retirement Communities 4600 - Legislative Findings and Purpose.

§ 4600. Legislative findings and purpose. The dramatic increase in the   numbers  of  elderly  people, especially those seventy-five years of age   and older, coupled with the special housing and  health  care  needs  of   this  growing segment of the population, requires the development of new   and creative approaches to help ensure  the  care  of  older  people  in   residential  settings  of  their  own  choice.  If carefully planned and   monitored, life  care  communities  have  the  potential  to  provide  a   continuum  of  care  for  older  people  that will provide an attractive   residential option for such persons, while meeting their long term  care   needs  for life. To ensure that the financial, consumer, and health care   interest  of  individuals  who  enroll  in  such  communities  will   be   protected,  such  communities  must be effectively managed and carefully   overseen.The intent of the legislature, therefore, is to allow for the  prudent   development  of  life care communities.  The legislature further intends   to require that the relevant state agencies coordinate the regulation of   such communities in order to ensure that there are  adequate  safeguards   for  those  elderly  who  become  residents and to assist in the orderly   development, of such communities. Although lead responsibility  for  the   interagency  coordination  of  the  regulation and establishment of such   communities is vested in the department of health, the legislature  does   not  intend  that  such  communities become or be perceived as primarily   medically-oriented facilities. The legislature  intends,  instead,  that   such  communities  be viewed as an attractive and innovative residential   alternative for older New Yorkers who are seeking to  maintain,  to  the   extent  possible, an independent and active life in a community in which   their long-term care needs will be met.
NY Pub Health L § 4605 (2021)
2021 New York Laws PBH - Public Health Article 46 - Continuing Care Retirement Communities 4605 - Certificate of Authority; Authority of Operator.

§  4605.  Certificate  of  authority;  authority  of  operator.  1.  A   certificate of authority shall authorize an operator:a. to operate a continuing care retirement community and to enter into   contracts pertaining to such community;b. to prepare and make public information that details  the  terms  of   any contract relating to a community;c.  to  advertise  the community and the related services that will be   provided pursuant to this article; andd. to  offer  and  execute  contracts,  including  the  collection  of   entrance  fees  and deposits pursuant to section forty-six hundred eight   of this article.2.  a.  The  commissioner,  in  consultation  with  the  council,  may   authorize  an  operator  of  a  community  with an on-site or affiliated   residential health care facility  to  provide,  for  a  limited  period,   residential  health  care  facility  services  to  persons,  who are not   residents of the community, provided, however, that the  operator  shall   not  discriminate in the admission, retention or care of any such person   because such person is or will be eligible  for,  or  receives  or  will   receive, medical assistance benefits pursuant to title eleven of article   five of the social services law.b.  The  commissioner, in consultation with the council, may authorize   an operator of a community with an  on-site  or  affiliated  adult  care   facility  to provide, for a limited period, adult care facility services   to persons, who are not residents of the community,  provided,  however,   that  the operator shall not discriminate in the admission, retention or   care of any such person because such person is or will be eligible  for,   or  receives  or  will  receive, medical assistance benefits pursuant to   title eleven of article five of the social services law or  supplemental   security income benefits pursuant to title sixteen of the federal social   security  act  and any additional state payments made under title six of   article five of the social services law.
NY Pub Health L § 4605-A (2021)
2021 New York Laws PBH - Public Health Article 46 - Continuing Care Retirement Communities 4605-A - Certificate of Authority; Authority to Offer Continuing Care at Home Contracts.

§ 4605-a. Certificate of authority; authority to offer continuing care at  home  contracts.  A  continuing  care retirement community may offer continuing care at home contracts upon approval by the council to  amend the  continuing care retirement community's certificate of authority. In order to qualify for an amendment to its certificate of  authority,  the continuing  care  retirement  community shall submit to the commissioner the following:   1. a  business  plan  to  the  commissioner  and  superintendent  that includes the following:  (a) a description of the continuing care at home services that will be provided,  the market that will be served by the continuing care at home contracts, and the fees to be charged to prospective continuing care  at home contract holders;  (b) a copy of the proposed continuing care at home contract; and  (c)   an  actuarial  study  prepared  by  an  independent  actuary  in accordance with standards adopted by the American Academy  of  Actuaries demonstrating the impact that the continuing care at home contracts will have  on  the  overall  operations  of  the  continuing  care retirement community and further demonstrating that the addition of continuing care at home contracts will not jeopardize  the  financial  solvency  of  the continuing care retirement community.   2.  a  market  feasibility study demonstrating to the commissioner and superintendent sufficient consumer interest in continuing care  at  home contracts and further demonstrating that the addition of continuing care at  home  contracts  will not have an adverse impact on the provision of services to continuing care retirement contract holders.   3. materials that meet all requirements established by  the  New  York state department of financial services.   4.  A  copy  of  the  notification  sent to continuing care retirement contract holders describing the anticipated impact of  the  addition  of continuing   care  at  home  contracts  on  continuing  care  retirement community  resources  and  proof  that  such   notification   has   been distributed to all continuing care retirement contract holders.
NY Pub Health L § 4605-B (2021)
2021 New York Laws PBH - Public Health Article 46 - Continuing Care Retirement Communities 4605-B - Certificate of Authority; Limitation on Continuing Care at Home Contracts.

§  4605-b.  Certificate of authority; limitation on continuing care at home contracts. The number of continuing care at home contracts approved on a certificate of authority shall be limited to:   1. The  number  of  approved  living  units  on  the  continuing  care retirement  community's  premises  that  are intended for ILU residents, except  that  the  council  may  approve  additional  contracts  upon  a submission  to  the  commissioner  by  an  operator  consistent with the provisions set  forth  in  section  forty-six  hundred  five-a  of  this article;   2. The demonstrated number of continuing care at home contract holders that can be supported in the existing or approved future capacity of the adult  care  facility  and  skilled nursing facility consistent with the provisions set  forth  in  section  forty-six  hundred  five-a  of  this article; and   3.  Conditions set forth by the New York state department of financial services, based upon the superintendent's assessment of the following:  (a) the overall financial impact on the community; and  (b) the submitted materials set forth  in  section  forty-six  hundred five-a of this article.