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

                                  8010

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                              May 26, 2011
                               ___________

Introduced by M. of A. CASTELLI -- read once and referred to the Commit-
  tee 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 (k) to read as follows:
  (K) 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.
                                                           LBD05483-01-1

              

A. 8010                             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.