Legislation
SECTION 2999-R
Other laws
Public Health (PBH) CHAPTER 45, ARTICLE 29-E
§ 2999-r. Other laws. 1. (a) It is the policy of the state to permit
and encourage cooperative, collaborative and integrative arrangements
among third-party health care payers and health care providers who might
otherwise be competitors under the active supervision of the
commissioner. To the extent that it is necessary to accomplish the
purposes of this article, competition may be supplanted and the state
may provide state action immunity under state and federal antitrust laws
to payors and health care providers.
(b) The commissioner shall engage in state supervision to promote
state action immunity under state and federal antitrust laws and may
inspect, require, or request additional documentation and take other
actions under this article to verify and make sure that this article is
implemented in accordance with its intent and purpose.
2. With respect to the planning, implementation, and operation of
ACOs, the commissioner, by regulation, shall specifically delineate safe
harbors that exempt ACOs from the application of the following statutes:
(a) article twenty-two of the general business law relating to
arrangements and agreements in restraint of trade;
(b) article one hundred thirty-one-A of the education law relating to
fee-splitting arrangements; and
(c) title two-D of article two of this chapter relating to health care
practitioner referrals.
3. For the purposes of this article, an ACO shall be deemed to be a
hospital for purposes of sections twenty-eight hundred five-j,
twenty-eight hundred five-k, twenty-eight hundred five-l and
twenty-eight hundred five-m of this chapter and subdivisions three and
five of section sixty-five hundred twenty-seven of the education law.
4. The commissioner is authorized to seek federal grants, approvals,
and waivers to implement this article, including federal financial
participation under public health coverage. The commissioner shall
provide copies of applications and other documents, including drafts,
submitted to the federal government seeking such federal grants,
approvals, and waivers to the chairs of the senate finance committee,
the assembly ways and means committee, and the senate and assembly
health committees simultaneously with their submission to the federal
government.
5. The commissioner may directly, or by contract with not-for-profit
organizations, provide:
(a) consumer assistance to patients served by an ACO as to matters
relating to ACOs;
(b) technical and other assistance to health care providers
participating in an ACO as to matters relating to the ACO;
(c) assistance to ACOs to promote their formation and improve their
operation, including assistance under section twenty-eight hundred
eighteen of this chapter; and
(d) information sharing and other assistance among ACOs to improve the
operation of ACOs.
and encourage cooperative, collaborative and integrative arrangements
among third-party health care payers and health care providers who might
otherwise be competitors under the active supervision of the
commissioner. To the extent that it is necessary to accomplish the
purposes of this article, competition may be supplanted and the state
may provide state action immunity under state and federal antitrust laws
to payors and health care providers.
(b) The commissioner shall engage in state supervision to promote
state action immunity under state and federal antitrust laws and may
inspect, require, or request additional documentation and take other
actions under this article to verify and make sure that this article is
implemented in accordance with its intent and purpose.
2. With respect to the planning, implementation, and operation of
ACOs, the commissioner, by regulation, shall specifically delineate safe
harbors that exempt ACOs from the application of the following statutes:
(a) article twenty-two of the general business law relating to
arrangements and agreements in restraint of trade;
(b) article one hundred thirty-one-A of the education law relating to
fee-splitting arrangements; and
(c) title two-D of article two of this chapter relating to health care
practitioner referrals.
3. For the purposes of this article, an ACO shall be deemed to be a
hospital for purposes of sections twenty-eight hundred five-j,
twenty-eight hundred five-k, twenty-eight hundred five-l and
twenty-eight hundred five-m of this chapter and subdivisions three and
five of section sixty-five hundred twenty-seven of the education law.
4. The commissioner is authorized to seek federal grants, approvals,
and waivers to implement this article, including federal financial
participation under public health coverage. The commissioner shall
provide copies of applications and other documents, including drafts,
submitted to the federal government seeking such federal grants,
approvals, and waivers to the chairs of the senate finance committee,
the assembly ways and means committee, and the senate and assembly
health committees simultaneously with their submission to the federal
government.
5. The commissioner may directly, or by contract with not-for-profit
organizations, provide:
(a) consumer assistance to patients served by an ACO as to matters
relating to ACOs;
(b) technical and other assistance to health care providers
participating in an ACO as to matters relating to the ACO;
(c) assistance to ACOs to promote their formation and improve their
operation, including assistance under section twenty-eight hundred
eighteen of this chapter; and
(d) information sharing and other assistance among ACOs to improve the
operation of ACOs.