§ 4307. Providers of services. (a) Any hospital service corporation or
health service corporation may provide benefits for the rendering of
hospital service to persons covered under its contracts (i) by hospitals
maintained by the state or any of its political subdivisions, or
maintained by a corporation organized for hospital purposes under the
not-for-profit corporation law, (ii) by such other hospitals,
convalescent institutions and nursing homes as shall have been approved
by the commissioner of health for such purpose, (iii) with such private
or public instrumentalities providing home nursing services as shall
have been approved by the commissioner of health for such purpose,
and/or (iv) subject to the approval of the superintendent, with similar
corporations of other states and hospitals of other states subject to
the supervision of such other states.

* (d) In the event a health maintenance organization which is either
licensed as a health service corporation under this article or is
operating pursuant to a certificate of authority granted in accordance
with the provisions of article forty-four of the public health law, or
any other health service corporation is deemed insolvent, as provided in
subsection (c) of section four thousand three hundred ten of this
article, then no individual subscriber or enrollee of, or served by, the
health maintenance organization or health service corporation shall be
liable to any provider of health care services for any covered services
of the insolvent health maintenance organization or health service
corporation. No provider of health care services or any representative
of such provider shall collect or attempt to collect from the individual
subscriber or enrollee sums owed by a health maintenance organization or
health service corporation deemed insolvent, and no provider or
representative of such provider may maintain any action at law against
an individual subscriber or enrollee to collect sums owed to such
provider by such health maintenance organization or health service
corporation.

* NB Amended by § 112-a and Repealed by § 143 of 639/96

* § 4307. Providers of services. (a) Any hospital service corporation
or health service corporation may provide benefits for the rendering of
hospital service to persons covered under its contracts (i) by hospitals
maintained by the state or any of its political subdivisions, or
maintained by a corporation organized for hospital purposes under the
not-for-profit corporation law, (ii) by such other hospitals,
convalescent institutions and nursing homes as shall have been approved
by the commissioner of health for such purpose, (iii) with such private
or public instrumentalities providing home nursing services as shall
have been approved by the commissioner of health for such purpose,
and/or (iv) subject to the approval of the superintendent, with similar
corporations of other states and hospitals of other states subject to
the supervision of such other states.

(b) All rates of payments to hospitals, nursing homes, convalescent
institutions and instrumentalities providing home nursing services made
by such corporation pursuant to the contracts provided for in subsection
(a) hereof shall prior to payment, (i) in the case of institutions
subject to article twenty-eight of the public health law, be certified
by the commissioner of health pursuant to the provisions of such article
twenty-eight of the public health law and approved by the
superintendent, and, (ii) in the case of other institutions, approved as
to reasonableness by the superintendent.

(c) Notwithstanding subsections (a) and (b) of this section, approval
by the superintendent shall not be required for rates of payment by
article forty-three corporations for in-patient hospital services
provided after December thirty-first, nineteen hundred eighty-three by
general hospitals subject to article twenty-eight of the public health
law.

(d) After approval by the superintendent each corporation organized
under this article shall notify each hospital and health related service
of its approved rates of payment for out-patient services, in instances
where such rates are determined on the basis of a cost based formula, at
least thirty days prior to the beginning of each rate year.

* NB Expired January 1, 1986. Remains effective prior to such date.
See ch 906/85 § 3