2013 New York Consolidated Laws
PBH - Public Health
Article 29-E - (2999-N - 2999-R) ACCOUNTABLE CARE ORGANIZATIONS
2999-P - Establishment of ACOs.

 
    §  2999-p. Establishment of ACOs. 1. An accountable care organization:
  (a) is an organization of clinically integrated  health  care  providers
  that  work  together  to  provide,  manage,  and  coordinate health care
  (including primary care) for a defined population; with a mechanism  for
  shared  governance;  the  ability  to negotiate, receive, and distribute
  payments; and accountability for the  quality,  cost,  and  delivery  of
  health  care to the ACO's patients; in accordance with this article; and
  (b) has been issued a certificate of authority by the commissioner under
  this article.
    2. The commissioner shall establish a program within the department to
  promote and regulate the use of ACOs to deliver an array of health  care
  services  for  the  purpose  of  improving the quality, coordination and
  accountability of services provided to patients in New York.
    3. The commissioner may issue a certificate of authority to an  entity
  that  meets conditions for ACO certification as set forth in regulations
  made  by  the  commissioner  pursuant  to  section  twenty-nine  hundred
  ninety-nine-q  of this article. The commissioner shall not issue any new
  certificate under this article after December thirty-first, two thousand
  sixteen.
    4.  (a)  Notwithstanding  subdivision  three  of  this  section,   the
  commissioner  shall  issue a certificate of authority as a Medicare-only
  ACO  to  an  entity  authorized  by  CMS  to  be  an  accountable   care
  organization  under  the Medicare program, upon receiving an application
  to be a Medicare-only ACO from the entity documenting its  status  under
  this  subdivision.  A  certificate  of  authority under this subdivision
  shall only apply to the  Medicare-only  ACO's  actions  in  relation  to
  Medicare beneficiaries under its authorization from CMS.
    (b) To the extent consistent with CMS regulations, a Medicare-only ACO
  shall be subject to:
    (i) subdivision seven of section twenty-nine hundred ninety-nine-q and
  subdivisions   one,   two  and  three  of  section  twenty-nine  hundred
  ninety-nine-r  of  this  article,  without   regard   to   whether   the
  commissioner has made regulations under this article; and
    (ii)  other  provisions  of  this  article  to the extent specifically
  provided  by  the  commissioner  in  regulations  consistent  with  this
  article.
    5.  The commissioner may limit, suspend, or terminate a certificate of
  authority if an ACO is not operating in accordance with this article.
    6. The commissioner  is  authorized  to  seek  federal  approvals  and
  waivers  to  implement  this article, including but not limited to those
  approvals   or   waivers   necessary   to   obtain   federal   financial
  participation.