§ 4806. Health care facility applications. (a) An insurer that offers
a managed care product shall, upon request, make available and disclose
to facilities written application procedures and minimum qualification
requirements that a facility must meet in order to be considered by the
insurer for participation in the in-network benefits portion of the
insurer's network for the managed care product. The insurer shall
consult with appropriately qualified facilities in developing its
qualification requirements for participation in the in-network benefits
portion of the insurer's network for the managed care product. An
insurer shall complete review of the facility's application to
participate in the in-network portion of the insurer's network and,
within sixty days of receiving a facility's completed application to
participate in the insurer's network, shall notify the facility as to:
(1) whether the facility is credentialed; or (2) whether additional time
is necessary to make a determination because of a failure of a third
party to provide necessary documentation. In such instances where
additional time is necessary because of a lack of necessary
documentation, an insurer shall make every effort to obtain such
information as soon as possible and shall make a final determination
within twenty-one days of receiving the necessary documentation.

(b) For the purposes of this section, "facility" shall mean a health
care provider that is licensed or certified pursuant to article five,
twenty-eight, thirty-six, forty, forty-four, or forty-seven of the
public health law or article sixteen, nineteen, thirty-one, thirty-two,
or thirty-six of the mental hygiene law.