NY Pub Health L § 4623 (2021)
2021 New York Laws PBH - Public Health Article 46 - Continuing Care Retirement Communities 4623 - Long Term Care Insurance and Continuing Care Retirement Contracts or Continuing Care at Home Contracts.

§  4623.  Long  term  care  insurance  and  continuing care retirement   contracts or continuing care at  home  contracts.  1.  The  council  may   approve   an   application  for  a  certificate  of  authority  and  the   commissioner may issue a certificate of authority for the  establishment   and  operation  of  a  continuing  care  retirement  community  under an   arrangement which otherwise  complies  with  the  requirements  of  this   article  except  that  the costs of nursing facility or home health care   services are paid for in  whole  or  in  part  by  (a)  long  term  care   insurance obtained and paid for by the resident or by medical assistance   payments  in  accordance with the partnership for long term care program   pursuant to section three hundred sixty-seven-f of the  social  services   law  and section three thousand two hundred twenty-nine of the insurance   law or (b) other group or individual long term care  insurance  approved   by   the   superintendent   and  the  council  in  connection  with  the   application. The council, in consultation with the superintendent, shall   provide for adequate disclosure to residents of  their  options,  rights   and obligations under such an arrangement, and shall establish standards   for the remittance and collection of premiums and monthly care fees.2.  With regard to nursing facility or home health care services which   are part of the continuing care retirement contract or  continuing  care   at   home   contract,   any  elimination  or  waiting  periods  and  any   deductibles, copayments, or other amounts not paid for by such long term   care  insurance  or   medical   assistance   payments   shall   be   the   responsibility of the continuing care retirement community. The resident   shall not be liable to pay any such amounts.3. The continuing care retirement community operator shall not require   that  long  term care insurance be purchased from a specified insurer or   group of insurers and the operator shall not, without  the  approval  of   the  council  and  the approval of the superintendent, specify a minimum   acceptable benefit level  different  from  that  established  under  the   partnership for long term care program.4.  Entrance fees and monthly care fees shall reflect that the cost of   a resident's nursing facility and home health care services are or  will   be  paid  for in whole or in part in accordance with (a) the partnership   for long term care program or (b) other group or  individual  long  term   care  insurance  approved  by  the  superintendent  and  the  council in   connection with the application.5. a. If a resident fails to maintain minimum long term care insurance   coverage in accordance with this section, the continuing care retirement   community operator shall purchase, if possible, such coverage on  behalf   of  and  at  the  expense of the resident and may require an appropriate   adjustment in payments by the resident to the operator.b.  If  the  continuing  care  retirement  community  operator  cannot   purchase  long  term  care  insurance coverage under paragraph a of this   subdivision, the operator may require an adjustment  in  the  resident's   monthly fees, subject to the approval of the superintendent, to fund the   additional risk to the facility.c. If the resident fails to maintain long term care insurance coverage   in  accordance  with  this  section  and  the community operator has not   purchased such coverage, the  operator  shall  be  responsible  for  any   expenses  which  would  have  been  covered  under  the  long  term care   insurance policy which the resident failed to maintain. The operator may   add the amount of such expenses to the resident's monthly fees.