Legislation
SECTION 587
Prohibited practices
Public Health (PBH) CHAPTER 45, ARTICLE 5, TITLE 6
§ 587. Prohibited practices. 1. No health services purveyor shall
solicit, receive, accept or agree to receive or accept any payment or
other consideration in any form to the extent such payment or other
consideration is given for the referral of services or participate in
the division, transference, assignment, rebate, splitting of fees, with
any clinical laboratory or its agent, employee or fiduciary, or with
another health services purveyor in relation to clinical laboratory
services. Specifically prohibited practices shall include, without
limiting thereto, the following:
(a) Acceptance of payments for rental of space for more than the fair
market value or where the rental amount is affected by test ordering
volume or value.
(b) Acceptance of rental payments for storage space for any supplies
provided by any clinical laboratory or its agent, employee or fiduciary.
(c) Acceptance of payments for filling in proper information on
laboratory request forms for tests.
(d) Receipt or acceptance of employees, agents or other fiduciaries of
any clinical laboratory to perform any duties in the facility of any
health services purveyor provided, however, that nothing in this
subdivision shall prohibit a hospital as defined in article twenty-eight
of this chapter or a health maintenance organization operating in
accordance with article forty-three of the insurance law or article
forty-four of this chapter and a clinical laboratory from contracting
for laboratory management services including the provision of technical
services and employees for the performance of functions directly related
to clinical laboratory operations.
(e) Receipt or acceptance of equipment, supplies or services provided
by any clinical laboratory or its agent, employee or fiduciary for less
than fair market value or when the purchase price or rental payment is
in any way related to the reference of patients or specimens to any
clinical laboratory.
(f) Receipt or acceptance of any monies or other consideration from
any clinical laboratory or its agent, employee or fiduciary as a bonus,
commission or fee in the form of a fixed or percentage return for the
number or dollar value of laboratory tests performed or to be performed
by any clinical laboratory to which patients or specimens are referred
or for the number of patients or specimens referred.
(g) The purchase of prepayment coupons, tickets, booklets or any
variation of such prepayment instruments as advance payments by
purveyors of health services for clinical laboratory services to be
rendered by any clinical laboratory.
(h) To accept payment of money or other consideration from anyone for
any clinical laboratory tests rendered or to be rendered on any specimen
for transference of the money or other consideration in whole or in part
to any clinical laboratory or to actually be kept by the health services
purveyor.
(i) To accept or use directly any instrument or any clinical
laboratory form marked "Invoice", "Receipt", "Payment Received" or any
other variation for issuance to patients as if the patient had been
billed and paid the clinical laboratory.
(j) Receipt or acceptance of any monies or other consideration from
any clinical laboratory or its agent, employee or fiduciary for
influencing any person to refrain from using or utilizing any other
clinical laboratory.
2. No clinical laboratory or its agent, employee or fiduciary shall
make, offer, give, or agree to make, offer, or give any payment or other
consideration in any form to the extent such payment or other
consideration is given for the referral of services or participate in
the division, transference, assignment, rebate, splitting of fees, with
any health services purveyor, or with another clinical laboratory.
Specifically prohibited practices shall include, without limiting
thereto, the following:
(a) To offer or agree to give or give any payments for rental of space
for more than the fair market value or where the rental amount is
affected by test ordering volume or value.
(b) To offer or agree to give or give rental payments for storage
space for any supplies provided to any health services purveyor.
(c) To offer or agree to give or give any payments for filling in
proper information on laboratory request forms for tests.
(d) To supply employees, agents or other fiduciaries of any clinical
laboratory to perform any duties in the facility of any health services
purveyor provided, however, that nothing in this subdivision shall
prohibit a hospital as defined in article twenty-eight of this chapter
or a health maintenance organization operating in accordance with
article forty-three of the insurance law or article forty-four of this
chapter and a clinical laboratory from contracting for laboratory
management services, including the provision of technical services and
employees for the performance of functions directly related to clinical
laboratory operations.
(e) To offer or agree to give or give any equipment, supplies or
services to any health services purveyor for less than fair market value
or when the purchase price or rental payment is in any way related to
the reference of patients or specimens to any clinical laboratory.
(f) To offer or agree to give or give any monies or other
consideration to any health services purveyor as a bonus, commission or
fee in the form of a fixed or percentage return for the number or dollar
value of laboratory tests performed or to be performed by any clinical
laboratory to which patients or specimens are referred or for the number
of patients or specimens referred.
(g) To sell any prepayment coupons, tickets, booklets or any variation
of such prepayment instrument as advance payments by purveyors of health
services for clinical laboratory services.
(h) To send a bill to or receive payment from any health services
purveyor for clinical laboratory services rendered to any patient, where
such bill is sent in code on blank paper, without name and address of
the clinical laboratory, without name or address of the addressee, or
without name or other identifying information of the person who was the
recipient of the laboratory service or in any other falsified manner.
(i) To utilize any health services purveyor or anyone else not
authorized by law to collect money or other consideration from anyone
for any clinical laboratory tests rendered or to be rendered on any
specimen for transference of the money or other consideration in whole
or in part to the clinical laboratory or to be actually kept by the
health services purveyor.
(j) To supply to any health services purveyor any printed form of a
clinical laboratory marked "Invoice", "Receipt", "Payment Received", or
any other variation for use by any health services purveyor issuing same
to patients as if the patient had paid the clinical laboratory.
(k) To offer or agree to give or give any monies or other
consideration for influencing any person to refrain from using or
utilizing any other clinical laboratory.
3. This section shall not apply to any: (a) legally established
hospital group purchasing program approved by the commissioner, or (b)
any arrangement between a clinical laboratory and health maintenance
organization operating in accordance with article forty-three of the
insurance law or article forty-four of this chapter approved by the
commissioner.
4. Any transaction excluded from the prohibition of section five
hundred eighty-six of this title relating to payment for services
rendered by clinical laboratories shall be deemed to be similarly
excluded from the application of this section.
5. No clinical laboratory or its agent, employee or fiduciary shall
make, offer, give or agree to make, offer or give to any person,
partnership, corporation or other entity any payment or other
consideration in any form as a bonus, commission or fee for securing
referrals of services to the clinical laboratory except for payments
made to a person who is an employee of the clinical laboratory.
6. The public health council shall adopt and amend rules and
regulations, subject to approval by the commissioner, to effectuate the
provisions and purposes of this section.
solicit, receive, accept or agree to receive or accept any payment or
other consideration in any form to the extent such payment or other
consideration is given for the referral of services or participate in
the division, transference, assignment, rebate, splitting of fees, with
any clinical laboratory or its agent, employee or fiduciary, or with
another health services purveyor in relation to clinical laboratory
services. Specifically prohibited practices shall include, without
limiting thereto, the following:
(a) Acceptance of payments for rental of space for more than the fair
market value or where the rental amount is affected by test ordering
volume or value.
(b) Acceptance of rental payments for storage space for any supplies
provided by any clinical laboratory or its agent, employee or fiduciary.
(c) Acceptance of payments for filling in proper information on
laboratory request forms for tests.
(d) Receipt or acceptance of employees, agents or other fiduciaries of
any clinical laboratory to perform any duties in the facility of any
health services purveyor provided, however, that nothing in this
subdivision shall prohibit a hospital as defined in article twenty-eight
of this chapter or a health maintenance organization operating in
accordance with article forty-three of the insurance law or article
forty-four of this chapter and a clinical laboratory from contracting
for laboratory management services including the provision of technical
services and employees for the performance of functions directly related
to clinical laboratory operations.
(e) Receipt or acceptance of equipment, supplies or services provided
by any clinical laboratory or its agent, employee or fiduciary for less
than fair market value or when the purchase price or rental payment is
in any way related to the reference of patients or specimens to any
clinical laboratory.
(f) Receipt or acceptance of any monies or other consideration from
any clinical laboratory or its agent, employee or fiduciary as a bonus,
commission or fee in the form of a fixed or percentage return for the
number or dollar value of laboratory tests performed or to be performed
by any clinical laboratory to which patients or specimens are referred
or for the number of patients or specimens referred.
(g) The purchase of prepayment coupons, tickets, booklets or any
variation of such prepayment instruments as advance payments by
purveyors of health services for clinical laboratory services to be
rendered by any clinical laboratory.
(h) To accept payment of money or other consideration from anyone for
any clinical laboratory tests rendered or to be rendered on any specimen
for transference of the money or other consideration in whole or in part
to any clinical laboratory or to actually be kept by the health services
purveyor.
(i) To accept or use directly any instrument or any clinical
laboratory form marked "Invoice", "Receipt", "Payment Received" or any
other variation for issuance to patients as if the patient had been
billed and paid the clinical laboratory.
(j) Receipt or acceptance of any monies or other consideration from
any clinical laboratory or its agent, employee or fiduciary for
influencing any person to refrain from using or utilizing any other
clinical laboratory.
2. No clinical laboratory or its agent, employee or fiduciary shall
make, offer, give, or agree to make, offer, or give any payment or other
consideration in any form to the extent such payment or other
consideration is given for the referral of services or participate in
the division, transference, assignment, rebate, splitting of fees, with
any health services purveyor, or with another clinical laboratory.
Specifically prohibited practices shall include, without limiting
thereto, the following:
(a) To offer or agree to give or give any payments for rental of space
for more than the fair market value or where the rental amount is
affected by test ordering volume or value.
(b) To offer or agree to give or give rental payments for storage
space for any supplies provided to any health services purveyor.
(c) To offer or agree to give or give any payments for filling in
proper information on laboratory request forms for tests.
(d) To supply employees, agents or other fiduciaries of any clinical
laboratory to perform any duties in the facility of any health services
purveyor provided, however, that nothing in this subdivision shall
prohibit a hospital as defined in article twenty-eight of this chapter
or a health maintenance organization operating in accordance with
article forty-three of the insurance law or article forty-four of this
chapter and a clinical laboratory from contracting for laboratory
management services, including the provision of technical services and
employees for the performance of functions directly related to clinical
laboratory operations.
(e) To offer or agree to give or give any equipment, supplies or
services to any health services purveyor for less than fair market value
or when the purchase price or rental payment is in any way related to
the reference of patients or specimens to any clinical laboratory.
(f) To offer or agree to give or give any monies or other
consideration to any health services purveyor as a bonus, commission or
fee in the form of a fixed or percentage return for the number or dollar
value of laboratory tests performed or to be performed by any clinical
laboratory to which patients or specimens are referred or for the number
of patients or specimens referred.
(g) To sell any prepayment coupons, tickets, booklets or any variation
of such prepayment instrument as advance payments by purveyors of health
services for clinical laboratory services.
(h) To send a bill to or receive payment from any health services
purveyor for clinical laboratory services rendered to any patient, where
such bill is sent in code on blank paper, without name and address of
the clinical laboratory, without name or address of the addressee, or
without name or other identifying information of the person who was the
recipient of the laboratory service or in any other falsified manner.
(i) To utilize any health services purveyor or anyone else not
authorized by law to collect money or other consideration from anyone
for any clinical laboratory tests rendered or to be rendered on any
specimen for transference of the money or other consideration in whole
or in part to the clinical laboratory or to be actually kept by the
health services purveyor.
(j) To supply to any health services purveyor any printed form of a
clinical laboratory marked "Invoice", "Receipt", "Payment Received", or
any other variation for use by any health services purveyor issuing same
to patients as if the patient had paid the clinical laboratory.
(k) To offer or agree to give or give any monies or other
consideration for influencing any person to refrain from using or
utilizing any other clinical laboratory.
3. This section shall not apply to any: (a) legally established
hospital group purchasing program approved by the commissioner, or (b)
any arrangement between a clinical laboratory and health maintenance
organization operating in accordance with article forty-three of the
insurance law or article forty-four of this chapter approved by the
commissioner.
4. Any transaction excluded from the prohibition of section five
hundred eighty-six of this title relating to payment for services
rendered by clinical laboratories shall be deemed to be similarly
excluded from the application of this section.
5. No clinical laboratory or its agent, employee or fiduciary shall
make, offer, give or agree to make, offer or give to any person,
partnership, corporation or other entity any payment or other
consideration in any form as a bonus, commission or fee for securing
referrals of services to the clinical laboratory except for payments
made to a person who is an employee of the clinical laboratory.
6. The public health council shall adopt and amend rules and
regulations, subject to approval by the commissioner, to effectuate the
provisions and purposes of this section.