2006 New York Code - Minimum Benefit Standards For Certain Long Term Care Plans.

 
    §  3229.  Minimum  benefit standards for certain long term care plans.
  (a) The minimum standards for an insurance plan, which may qualify under
  the partnership for long term care program  pursuant  to  section  three
  hundred  sixty-seven-f  of the social services law, shall be established
  by  regulations  of  the  superintendent,  in  consultation   with   the
  commissioner  of  health  and  the  director of the state office for the
  aging, as approved by the director of the budget, which shall require at
  a minimum (1) a residential health care facility benefit in an amount to
  be determined by the regulations of the superintendent; (2) a home  care
  benefit  with  personal  care,  nursing  care, adult day health care and
  respite care services, which shall provide total benefits in  an  amount
  determined  by  regulations  of  the  superintendent;  (3) a duration of
  benefits not less than twelve months; and (4) arrangements  through  the
  insurance  plan  for managed care including preauthorized assessment and
  referral programs, utilization controls and use of approved providers.
    (b) In establishing minimum  benefit  standards  for  insurance  plans
  pursuant  to  this  section, the superintendent shall seek to ensure the
  cost effectiveness  of  the  partnership  for  long  term  care  program
  established  pursuant  to  section  three  hundred  sixty-seven-f of the
  social services law, and  may  establish  minimum  permissible  payments
  under  such  insurance  plans.  The  superintendent shall not approve an
  insurance plan which includes an exclusion for  pre-existing  conditions
  that exceeds six months.