2013 New York Consolidated Laws
PBH - Public Health
Article 44 - (4400 - 4414) HEALTH MAINTENANCE ORGANIZATIONS
4402 - Health maintenance organizations; application for certificate of authority.

 
    §  4402. Health maintenance organizations; application for certificate
  of authority. 1. No person or groups of persons  may  operate  a  health
  maintenance  organization  or  issue  a  contract  to  an  enrollee  for
  membership  in  a  comprehensive  health  services  plan  without  first
  obtaining a certificate of authority from the commissioner.
    2.  In  order  to receive such a certificate of authority, a person or
  persons, hereinafter designated as the applicant, intending to operate a
  health maintenance organization  shall  file  an  application  for  such
  certificate  on such form as the commissioner shall prescribe, and shall
  provide to the satisfaction of the commissioner the following:
    (a)  a  copy  of  each  of  the  basic  organizational  documents  and
  agreements  of  the  applicant and all participating entities, including
  all contracts and agreements relating to the provision of  comprehensive
  health services;
    (b)  a copy of the bylaws, rules and regulations on internal governing
  documents of the applicant;
    (c) a list of the names,  addresses  and  official  positions  of  the
  persons  comprising  the  applicant  and  all  entities  referred  to in
  paragraph (a) other than those possessing a valid operating  certificate
  under  the provisions of article twenty-eight of this chapter, including
  all owners of record or beneficial, all members of the  governing  body,
  the  officers  and  directors  in  the  case  of  a corporation, and the
  partners or members in the case of a partnership or corporation, and the
  agent for service of process;
    (d) a statement  of  the  financial  condition  of  the  organization,
  including,  if  appropriate,  an  income  statement,  balance  sheet and
  projected sources and uses of funds;
    (e) a statement generally describing the  proposed  operation  of  the
  health  maintenance  organization  as to the location of its facilities,
  the type and quantity  of  health  care  personnel  engaged  to  provide
  services,  its  quality  assurance  mechanism,  its grievance procedure,
  participating hospitals and such other data as may be  required  by  the
  commissioner;
    (f)  a  copy  of each enrollee contract filed with and approved by the
  superintendent pursuant  to  section  forty-four  hundred  six  of  this
  article; and
    (g)  such  other information as may be required by the commissioner to
  make the determinations required in section forty-four hundred three  of
  this article.