S T A T E   O F   N E W   Y O R K
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                                  7484

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                             April 13, 2009
                               ___________

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:

  Section 1. Section 1108 of the insurance law is amended  by  adding  a
new subsection (j) to read as follows:
  (J)  EVERY  HEALTH  CARE RETAINER PROGRAM OPERATED PURSUANT TO ARTICLE
FIFTY-SEVEN OF THIS CHAPTER.
  S 2. The insurance law is amended by adding a new article 57  to  read
as follows:
                                ARTICLE 57
                      HEALTH CARE RETAINER PROGRAMS
SECTION 5701. DEFINITIONS.
        5702. HEALTH CARE RETAINER PROGRAMS.
  S 5701. DEFINITIONS. AS USED IN THIS ARTICLE:
  (A)  "AGREEMENT"  SHALL  MEAN A HEALTH CARE RETAINER AGREEMENT ENTERED
INTO PURSUANT TO A PROGRAM OPERATED  BY  A  PRIMARY  CARE  PHYSICIAN  OR
PRIMARY CARE PHYSICIANS.
  (B) "PRIMARY CARE" SHALL MEAN PROFESSIONAL MEDICAL CARE OFFERED IN THE
FIELDS  OF  FAMILY  PRACTICE,  GENERAL PEDIATRICS, PRIMARY CARE INTERNAL
MEDICINE, AND PRIMARY CARE OBSTETRICS AND GYNECOLOGY, AND AS DEFINED  IN
THE RULES AND REGULATIONS OF THE COMMISSIONER OF HEALTH.
  (C)  "PRIMARY CARE PHYSICIAN" SHALL MEAN A PERSON LICENSED TO PRACTICE
MEDICINE IN THIS STATE WHOSE PRIMARY FIELD OF PRACTICE IS PRIMARY CARE.
  (D) "PRIMARY CARE PRACTITIONER" SHALL MEAN A  MIDWIFE,  NURSE  PRACTI-
TIONER  OR PHYSICIAN ASSISTANT AUTHORIZED TO PRACTICE IN THIS STATE, WHO
PROVIDES PRIMARY CARE, AND WHO IS SUBJECT TO THE SUPERVISION AND  DIREC-
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

  (E)  "PROGRAM"  SHALL  MEAN A HEALTH CARE RETAINER PROGRAM OFFERED AND
OPERATED BY A PRIMARY CARE PHYSICIAN OR A GROUP OF PRIMARY  CARE  PHYSI-
CIANS WHEREBY SUCH PHYSICIAN OR PHYSICIANS, AND PRIMARY CARE PRACTITION-
ERS  UNDER THE CONTROL OF SUCH PHYSICIAN OR PHYSICIANS, AGREE TO PROVIDE
ALL NECESSARY PRIMARY CARE TO ANY PERSON ENTERING INTO AN AGREEMENT, AND
THEIR  DEPENDENTS,  FOR  A  CERTAIN PERIOD OF TIME IN EXCHANGE FOR A FEE
ESTABLISHED UPON ENTERING INTO THE AGREEMENT.
  S 5702. HEALTH CARE RETAINER PROGRAMS. ANY PRIMARY CARE  PHYSICIAN  OR
GROUP OF PRIMARY CARE PHYSICIANS MAY ESTABLISH AND OPERATE A HEALTH CARE
RETAINER PROGRAM SUBJECT TO THE PROVISIONS OF THIS SECTION.
  (A)  EVERY  AGREEMENT  SHALL  BE WRITTEN IN CLEAR, CONCISE AND EASY TO
UNDERSTAND LANGUAGE, AND FULLY DEFINE THE PRIMARY CARE SERVICES  COVERED
BY  SUCH  AGREEMENT, THE FEE FOR THE PROVISION OF SUCH SERVICES, AND THE
PERIOD OF TIME SUCH SERVICES ARE TO BE PROVIDED FOR SUCH FEE.
  (B) EVERY AGREEMENT SHALL BE LIMITED TO THE PROVISION OF PRIMARY CARE.
  (C) ALL FEES AND CHARGES PAID FOR AGREEMENTS SHALL BE DEPOSITED BY THE
OPERATORS OF A  PROGRAM  IN  AN  UNSEGREGATED  INTEREST-BEARING  DEPOSIT
ACCOUNT  WITH  A  BANKING  INSTITUTION,  AS  DEFINED IN THE BANKING LAW.
MONEYS SHALL BE PAID OUT OF SUCH ACCOUNT  ONLY  IN  SUCH  AMOUNT  AS  IS
EQUIVALENT TO THE FEES AND CHARGES FOR PRIMARY CARE DELIVERED DURING THE
PRECEDING CALENDAR MONTH.
  (D) EVERY PROGRAM SHALL, ON OR BEFORE FEBRUARY FIRST EACH YEAR, SUBMIT
AN  AFFIDAVIT TO THE SUPERINTENDENT ATTESTING TO ITS COMPLIANCE WITH THE
PROVISIONS OF THIS ARTICLE DURING  THE  IMMEDIATELY  PRECEDING  CALENDAR
YEAR.
  S 3. This act shall take effect immediately.