There is a newer version of the New York Consolidated Laws
2006 New York Code - Managed Long Term Care Plans.
* § 4403-f. Managed long term care plans. 1. Definitions. As used in
this section:
(a) "Managed long term care plan" means an entity that has received a
certificate of authority pursuant to this section to provide, or arrange
for, health and long term care services, on a capitated basis in
accordance with this section, for a population, age eighteen and over,
which the plan is authorized to enroll.
(b) "Eligible applicant" means an entity controlled or wholly owned by
one or more of the following: a hospital as defined in subdivision one
of section twenty-eight hundred one of this chapter; a home care agency
licensed or certified pursuant to article thirty-six of this chapter; an
entity that has received a certificate of authority pursuant to sections
forty-four hundred three, forty-four hundred three-a or forty-four
hundred eight-a of this article (as added by chapter six hundred
thirty-nine of the laws of nineteen hundred ninety-six), or a health
maintenance organization authorized under article forty-three of the
insurance law; or a not-for-profit organization which has a history of
providing or coordinating health care services and long term care
services to the elderly and disabled.
(c) "Chronically ill" shall be as defined by the commissioner.
(d) "Operating demonstration" means the following entities: the social
health maintenance organization authorized by chapter six hundred two of
the laws of nineteen hundred eighty-two; and the chronic care management
demonstration programs authorized by chapters six hundred fifty-three of
the laws of nineteen hundred eighty-four, chapter five hundred thirty of
the laws of nineteen hundred eighty-eight, chapter five hundred
ninety-seven of the laws of nineteen hundred ninety-four and chapter
eighty-one of the laws of nineteen hundred ninety-five as amended.
(e) "Approved managed long term care demonstration" means the sites
approved by the commissioner to participate in the "Evaluated Medicaid
Long Term Care Capitation Program"; the chronic care management
demonstration program authorized by chapter thirty-nine of the laws of
nineteen hundred ninety-seven; and any demonstration authorized pursuant
to paragraphs (d) and (e) of subdivision six of this section.
(f) "Health and long term care services" means services including, but
not limited to primary care, acute care, home and community-based and
institution-based long term care and ancillary services (that shall
include medical supplies and nutritional supplements) that are necessary
to meet the needs of persons whom the plan is authorized to enroll.
2. Certificate of authority; form. An eligible applicant shall submit
an application for a certificate of authority to operate a managed long
term care plan upon forms, and within such time, as may be prescribed by
the commissioner. Such eligible applicant shall submit information and
documentation to the commissioner which shall include, but not be
limited to:
(a) a description of the service area proposed to be served by the
plan with projections of enrollment that will result in a fiscally sound
plan;
(b) a description of the proposed target population and the marketing
plan;
(c) a description that demonstrates the cost-effectiveness of the
program as compared to the cost of services clients would otherwise have
received;
(d) adequate documentation of the appropriate licenses, certifications
or approvals to provide care as planned, including, if appropriate,
affiliation agreements or contracts with such providers as may be
necessary to provide the full complement of services required to be
provided under this section.
3. Certificate of authority; approval. The commissioner shall not
approve an application for a certificate of authority unless the
applicant demonstrates to the commissioner's satisfaction:
(a) the relative cost effectiveness to the medical assistance program
when compared to other managed long term care plans proposing to serve,
or serving, comparable populations;
(b) that it will have in place acceptable quality-assurance
mechanisms, grievance procedures, mechanisms to protect the rights of
enrollees and case management services to ensure continuity, quality,
appropriateness and coordination of care;
(c) that it will include an enrollment process which shall ensure that
enrollment in the plan is informed and voluntary by enrollees or their
representatives and a voluntary disenrollment process. The application
shall include the specific grounds that would warrant involuntary
disenrollment provided, however, an otherwise eligible enrollee shall
not be involuntarily disenrolled on the basis of health status;
(d) satisfactory evidence of the character and competence of the
proposed operators and reasonable assurance that the applicant will
provide high quality services to an enrolled population;
(e) sufficient management systems capacity to meet the requirements of
this section and the ability to efficiently process payment for covered
services;
(f) readiness and capability to: achieve full capitation on a
scheduled basis for services reimbursed pursuant to title XVIII of the
federal social security act or capability and protocols for benefit
coordination for services reimbursed pursuant to such title and all
other applicable benefits, with such benefit coordination including, but
not limited to, measures to support sound clinical decisions, reduce
administrative complexity, coordinate access to services, maximize
benefits available pursuant to such title and ensure that necessary care
is provided;
(g) readiness and capability to achieve full capitation on a scheduled
basis for services reimbursed pursuant to title XIX of the federal
social security act;
(h) willingness and capability of taking, or cooperating in, all steps
necessary to secure and integrate any potential sources of funding for
services provided by the managed long term care plan, including, but not
limited to, funding available under titles XVI, XVIII, XIX and XX of the
federal social security act, the federal older Americans act of nineteen
hundred sixty-five, as amended, or any successor provisions subject to
approval of the director of the state office for aging, and through
financing options such as those authorized pursuant to section three
hundred sixty-seven-f of the social services law; and
(i) that the arrangements for health and long term care services
ensure the availability and accessibility of such services to the
proposed enrolled population.
4. Role of the superintendent of insurance. (a) The superintendent of
insurance, in consultation with the commissioner with regard to fiscal
solvency, shall be responsible for evaluating, approving and regulating
all matters relating to premium rates subject to paragraph (c) of this
subdivision, enrollee contracts and fiscal solvency, including reserves,
surplus and provider contracts to the extent such contracts relate to
fiscal solvency matters. The superintendent of insurance may promulgate
regulations to implement this section. The superintendent of insurance,
in the administration of this subdivision:
(i) shall be guided by the standards which govern the fiscal solvency
of a health maintenance organization, provided, however, that the
superintendent of insurance shall recognize the specific delivery
components, operational capacity and financial capability of the
eligible applicant for a certificate of authority;
(ii) shall not apply financial solvency standards that exceed those
required for a health maintenance organization;
(iii) shall establish reasonable capitalization and contingency
reserve requirements. Where the population enrolled in a managed long
term care plan is substantially composed of chronically ill individuals
receiving services under title XIX of the federal social security act,
the superintendent of insurance shall take into consideration the
availability of services to such chronically ill individuals under such
title in the event that the managed long term care plan is unable to
meet its contractual obligations. The establishment of reasonable
capitalization and contingency reserve requirements for managed long
term care plans substantially composed of chronically ill individuals
receiving services under title XIX of the federal social security act
shall also be subject to the approval of the commissioner;
(iv) when establishing capitalization and contingency reserve
requirements, may exclude revenue and expenses derived from chronically
ill individuals under title XIX of the federal social security act who
are in a nursing facility in a managed long term care plan.
(b) Standards established pursuant to this subdivision shall be
adequate to protect the interests of enrollees in managed long term care
plans. The superintendent of insurance shall be satisfied that the
eligible applicant is financially sound, and has made adequate
provisions to pay for services:
(i) that are furnished by providers that are not affiliated with the
eligible applicant;
(ii) to meet the specialized health care needs of enrollees needing
care at specialty care centers; and
(iii) for which claims are submitted after the period for which the
eligible applicant will receive payments.
(c) A managed long term care plan shall have its premiums determined
in accordance with the insurance law except where enrollees are eligible
to receive services under title XIX of the federal social security act,
in which case rates shall be established pursuant to subdivision eight
of this section.
5. Applicability of other laws. (a) A managed long term care plan or
approved managed long term care demonstration shall be subject to the
provisions of the insurance law and regulations applicable to health
maintenance organizations, this article and regulations promulgated
pursuant thereto. To the extent that the provisions of this section are
inconsistent with the provisions of this chapter or the provisions of
the insurance law, the provisions of this section shall prevail.
(b) Notwithstanding chapter thirty-nine of the laws of nineteen
hundred ninety-seven, the provisions of this section shall apply to the
chronic care management demonstration authorized by such chapter.
6. Approval authority. (a) The commissioner, pursuant to a request for
proposals selection process, after receiving from the superintendent of
insurance the evaluations and approvals required pursuant to this
section, shall issue no more than thirty certificates of authority to
eligible applicants for a managed long term care plan which satisfies
the conditions under this section, provided that:
(i) for the purposes of issuance of no more than thirty certificates,
such certificates shall be exclusive of those certificates issued
pursuant to paragraphs (b) and (c) of this subdivision, provided,
however, that such certificates shall be inclusive of those certificates
issued to entities initially authorized to operate as an approved
managed long term care demonstration pursuant to paragraph (e) of this
subdivision;
(ii) no more than nine of the thirty certificates of authority,
inclusive of those certificates issued to entities initially authorized
to operate as an approved managed long term care demonstration pursuant
to paragraph (e) of this subdivision may be issued to eligible
applicants which are, or are owned or controlled by one or more entities
that have received a certificate of authority pursuant to either section
forty-four hundred three, forty-four hundred three-a or forty-four
hundred eight-a of this article (as added by chapter six hundred
thirty-nine of the laws of nineteen hundred ninety-six) or a health
maintenance organization organized under article forty-three of the
insurance law provided further, that no more than one such certificate
may be issued to an eligible applicant described in this subparagraph in
the first twelve months following the effective date of this section,
and no more than two such certificates may be issued to eligible
applicants described in this subparagraph in the first twelve months
commencing with the selection, pursuant to a request for proposals, of
eligible applicants to operate managed long term care plans pursuant to
this paragraph. For purposes of this subparagraph, "control" shall exist
if an entity or entities designated in this subparagraph directly or
indirectly own, control, or hold the power to vote ten percent or more,
in the aggregate, of the voting securities or voting rights of such
eligible applicant, or are corporate members of an eligible applicant
organized as a not-for-profit corporation;
(iii) absent federal approvals as may be necessary to achieve the full
capitation requirements of paragraph (g) of subdivision three of this
section, the commissioner shall approve no more than eight certificates
of authority pursuant to this paragraph to operate a managed long term
care plan which requires such federal approvals.
(b) An operating demonstration shall be issued a certificate of
authority as a managed long term care plan upon a determination by the
commissioner, subject to the necessary evaluations, approvals and
regulations of the superintendent of insurance as stated in this
section, that such demonstration complies with the operating
requirements for a managed long term care plan under this section.
Except as otherwise expressly provided in paragraphs (d) and (e) of
subdivision seven of this section, nothing in this section shall be
construed to affect the continued legal authority of an operating
demonstration to operate its previously approved program.
(c) An approved managed long term care demonstration shall be issued a
certificate of authority as a managed long term care plan upon a
determination by the commissioner, subject to the necessary evaluations,
approvals and regulations of the superintendent of insurance set forth
in this section, that such demonstration complies with the operating
requirements for a managed long term care plan under this section.
Notwithstanding any inconsistent provision of law to the contrary, all
authority for the operation of approved managed long term care
demonstrations which have not been issued a certificate of authority as
a managed long term care plan, shall expire one year after the adoption
of regulations implementing managed long term care plans.
(d) The commissioner may, contingent upon approval of federal waivers
and subject to the approval of the director of the budget, authorize the
continuing care network demonstration program sites in Monroe county to
operate as approved managed long term care demonstrations and may permit
such sites to serve enrollees who are sixty-five and older and not
chronically ill.
(e) The majority leader of the senate and the speaker of the assembly
may each designate in writing up to ten eligible applicants as approved
managed long term care demonstrations. The commissioner may designate in
writing up to two eligible applicants as approved managed long term care
demonstrations. Subsequent to such designation, the commissioner and the
superintendent of insurance shall impose terms and conditions pursuant
to a written agreement with each such demonstration, not inconsistent
with this section, under which such demonstrations shall be authorized
to operate. If any such demonstration has not commenced operations by
January first, two thousand four, the majority leader of the senate or
the speaker of the assembly, as the case may be, may, consistent with
this paragraph, rescind its designation as an approved managed long term
care demonstration and its authorization to operate, and, consistent
with this paragraph, designate an alternate applicant as an approved
managed long term care demonstration.
(f) The commissioner and the superintendent of insurance shall impose
terms and conditions pursuant to a written agreement with each approved
managed long term care demonstration, not inconsistent with this
section, under which such demonstrations shall be authorized to operate.
7. Program oversight and administration. (a)(i) The commissioner shall
promulgate regulations to implement this section and to ensure the
quality, appropriateness and cost-effectiveness of the services provided
by managed long term care plans. The commissioner may waive rules and
regulations of the department, including but not limited to, those
pertaining to duplicative requirements concerning record keeping, boards
of directors, staffing and reporting, when such waiver will promote the
efficient delivery of appropriate, quality, cost-effective services and
when the health, safety and general welfare of enrollees will not be
impaired as a result of such waiver. In order to achieve managed long
term care plan system efficiencies and coordination and to promote the
objectives of high quality, integrated and cost effective care, the
commissioner may establish a single coordinated surveillance process,
allow for a comprehensive quality improvement and review process to meet
component quality requirements, and require a uniform cost report. The
commissioner shall require managed long term care plans to utilize
quality improvement measures, based on health outcomes data, for
internal quality assessment processes and may utilize such measures as
part of the single coordinated surveillance process.
(ii) Notwithstanding any inconsistent provision of the social services
law to the contrary, the commissioner shall, pursuant to regulation,
determine whether and the extent to which the applicable provisions of
the social services law or regulations relating to approvals and
authorizations of, and utilization limitations on, health and long term
care services reimbursed pursuant to title XIX of the federal social
security act, including, but not limited to, fiscal assessment
requirements, are inconsistent with the flexibility necessary for the
efficient administration of managed long term care plans and such
regulations shall provide that such provisions shall not be applicable
to enrollees or managed long term care plans, provided that such
determinations are consistent with applicable federal law and
regulation.
(b) The commissioner shall, to the extent necessary, submit the
appropriate waivers, including, but not limited to, those authorized
pursuant to sections eleven hundred fifteen and nineteen hundred fifteen
of the federal social security act, or successor provisions, and any
other waivers necessary to achieve the purposes of high quality,
integrated, and cost effective care and integrated financial eligibility
policies under the medical assistance program or pursuant to title XVIII
of the federal social security act. Copies of such original waiver
applications shall be provided to the chairman of the senate finance
committee and the chairman of the assembly ways and means committee
simultaneously with their submission to the federal government.
(c)(i) The commissioner may establish interim enrollment thresholds
which are less than the projected total enrollment in a plan for the
purpose of making a determination of the plan's ability to enroll
additional persons above the established thresholds while providing high
quality and accessible care. Total enrollment of persons enrolled in
managed long term care plans certified under paragraph (a) of
subdivision six of this section or initially authorized to operate as an
approved managed long term care demonstration under paragraph (e) of
such subdivision, shall not exceed, in the aggregate, twenty-five
thousand persons who were chronically ill and eligible for services
under title XIX of the federal social security act at the time of
enrollment and twenty-five thousand persons who were not chronically ill
at the time of enrollment.
(ii) A managed long term care plan shall not use deceptive or coercive
marketing methods to encourage participants to enroll. A managed long
term care plan shall not distribute marketing materials to potential
enrollees until such plan has submitted such materials to the
commissioner, the superintendent of insurance and the director of the
state office for the aging.
(iii) The commissioner shall ensure, through periodic reviews of
managed long term care plans, that enrollment was a voluntary and
informed choice; such plan has only enrolled persons whom it is
authorized to enroll, and plan services are promptly available to
enrollees when appropriate. Such periodic reviews shall be made
according to standards as determined by the commissioner in regulations.
(d) Notwithstanding any provision of law, rule or regulation to the
contrary and subject to the availability of funds, the commissioner
shall issue a request for proposals to carry out reviews of enrollment
and assessment activities in managed long term care plans and operating
demonstrations with respect to enrollees eligible to receive services
under title XIX of the federal social security act to determine if
enrollment meets the requirements of subparagraph (iii) of paragraph (c)
of this subdivision; and that assessments of such enrollees' health,
functional and other status, for the purpose of adjusting premiums, were
accurate. The request for proposals shall be developed, and proposals
evaluated, in consultation with the local commissioners representing the
several regions of the state. Evaluations shall address each bidder's
ability to ensure that enrollments in such plans are promptly reviewed
and that medical assistance required to be furnished pursuant to title
eleven of article five of the social services law will be appropriately
furnished to the recipients for whom the local commissioners are
responsible pursuant to section three hundred sixty-five of such title
and that plan implementation will be consistent with the proper and
efficient administration of the medical assistance program and managed
long term care plans.
(e) Until such time as the provisions of paragraph (d) of this
subdivision and the risk adjustment mechanisms referred to in
subdivision eight of this section are both implemented to the
satisfaction of the commissioner or January first, nineteen hundred
ninety-nine, whichever is earlier: (i) with respect to each managed long
term care plan, the commissioner may continue to delegate some, or all,
of the tasks identified in paragraph (d) of this subdivision to local
districts provided that the agreement between the department and such
plan pursuant to paragraph (o) of subdivision two of section three
hundred sixty-five-a of the social services law or between the
department and such demonstration clearly reflects such delegation; (ii)
an operating demonstration shall, with respect to tasks performed by the
local district in relation to such demonstrations, have the option of
continuing to operate under its existing agreement with a local district
or, in the event that an approved managed long term care demonstration
enters into a subsequent agreement with such district, to operate under
the same or similar terms and conditions as contained in such subsequent
agreement with respect to such tasks.
(f) The commissioner shall set a schedule for achievement of full
capitation for services reimbursed under title XIX of the federal social
security act which shall reflect the shortest feasible timelines
consistent with any federal approvals required to achieve full
capitation and the commissioner shall monitor each managed long term
care plan's movement to full capitation according to such schedule.
(g) The commissioner shall ensure that protocols for benefit
coordination, if applicable, have been implemented and are consistent
with the requirements of this section.
(h) The commissioner may, in his or her discretion for the purpose of
protection of enrollees, impose measures including, but not limited to,
bans on further enrollments and requirements for use of enrollment
brokers until any identified problems are resolved to the satisfaction
of the commissioner.
(i) Continuation of a certificate of authority issued under this
section, subject to the necessary evaluations, approvals and regulations
of the superintendent of insurance, shall be contingent upon
satisfactory performance by the managed long term care plan in the
delivery, continuity, accessibility, cost effectiveness and quality of
the services to enrolled members; compliance with applicable provisions
of this section and rules and regulations promulgated thereunder; the
continuing fiscal solvency of the organization; and, federal financial
participation in payments on behalf on enrollees who are eligible to
receive services under title XIX of the federal social security act.
(j) The commissioner shall ensure that (i) a process exists for the
resolution of disputes concerning the accuracy of assessments performed
pursuant to paragraphs (d) and (e) of this subdivision; and (ii) the
tasks described in paragraphs (d) and (e) of this subdivision are
consistently administered.
(k) (i) Managed long term care plans and demonstrations may enroll
eligible persons in the plan or demonstration upon the completion of a
comprehensive assessment that shall include, but not be limited to, an
evaluation of the medical, social and environmental needs of each
prospective enrollee in such program. This assessment shall also serve
as the basis for the development and provision of an appropriate plan of
care for the prospective enrollee.
(ii) The assessment shall be completed by a representative of the
managed long term care plan or demonstration, in consultation with the
prospective enrollee's health care practitioner. The commissioner shall
prescribe the forms on which the assessment shall be made.
(iii) The completed assessment and documentation of the enrollment
shall be submitted by the managed long term care plan or demonstration
to the local department of social services prior to the commencement of
services under the managed long term care plan or demonstration. For
purposes of reimbursement of the managed long term care plan or
demonstration, if the completed assessment and documentation are
submitted on or before the twentieth day of the month, the enrollment
shall commence on the first day of the month following the completion
and submission and if the completed assessment and documentation are
submitted after the twentieth day of the month, the enrollment shall
commence on the first day of the second month following submission.
Enrollments conducted by a plan or demonstration shall be subject to
review and audit by the department and the local social services
district.
(iv) Continued enrollment in a managed long term care plan or
demonstration paid for by government funds shall be based upon a
comprehensive assessment of the medical, social and environmental needs
of the recipient of the services. Such assessment shall be performed at
least annually by the managed long term care plan serving the enrollee.
The commissioner shall prescribe the forms on which the assessment will
be made.
(l) The commissioner shall, upon request by a managed long term care
plan, approved managed long term care demonstration, or operating
demonstration, and consistent with federal regulations promulgated
pursuant to the Health Insurance Portability and Accountability Act,
share with such plan or demonstration the following data if it is
available:
(i) information concerning utilization of services and providers by
each of its enrollees prior to and during enrollment, including but not
limited to utilization of emergency department services, prescription
drugs, and hospital and nursing facility admissions.
(ii) aggregate data concerning utilization and costs for enrollees and
for comparable cohorts served through the Medicaid fee-for-service
program.
8. Payment rates for managed long term care plan enrollees eligible
for medical assistance. The commissioner, in consultation with the
superintendent of insurance, shall establish payment rates for services
provided to enrollees eligible under title XIX of the federal social
security act. Such payment rates shall be subject to approval by the
director of the division of the budget and shall reflect savings to both
state and local governments when compared to costs which would be
incurred by such program if enrollees were to receive comparable health
and long term care services on a fee-for-service basis in the geographic
region in which such services are proposed to be provided. Payment rates
shall be risk-adjusted to take into account the characteristics of
enrollees, or proposed enrollees, including, but not limited to:
frailty, disability level, health and functional status, age, gender,
the nature of services provided to such enrollees, and other factors as
determined by the commissioner in consultation with the superintendent
of insurance. The risk adjusted premiums may also be combined with
disincentives or requirements designed to mitigate any incentives to
obtain higher payment categories.
9. Reports. The department shall provide an interim report to the
governor, temporary president of the senate and the speaker of the
assembly on or before April first, two thousand three and a final report
on or before April first, two thousand six on the results of the managed
long term care plans under this section. Such results shall be based on
data provided by the managed long term care plans and shall include but
not be limited to the quality, accessibility and appropriateness of
services; consumer satisfaction; the mean and distribution of impairment
measures of the enrollees by payor for each plan; the current method of
calculating premiums and the cost of comparable health and long term
care services provided on a fee-for-service basis for enrollees eligible
for services under title XIX of the federal social security act; and the
results of periodic reviews of enrollment levels and practices. Such
reports shall contain a section prepared by the superintendent of
insurance as to the results of the plans approved in accordance with
this section concerning the matters regulated by the superintendent of
insurance. Such reports shall also provide data on the demographic and
clinical characteristics of enrollees, voluntary and involuntary
disenrollments from plans, utilization of services and shall examine the
feasibility of increasing the number of plans that may be approved. Data
collected pursuant to this section shall be available to the public in
an aggregated format to protect individual confidentiality, however
under no circumstance will data be released on items with cells with
smaller than statistically acceptable standards.
10. Managed long term care advisory council. (a) There is hereby
established a council to advise the commissioner and the superintendent
of insurance on issues related to managed long term care. The council
shall consist of thirteen members who shall be appointed as follows:
seven by the governor, one of whom shall serve as the chair; two each by
the temporary president of the senate and the speaker of the assembly;
and one each by the minority leader of the senate and the minority
leader of the assembly. The appointees shall be persons knowledgeable in
the delivery or financing of continuing care services, or shall have a
demonstrated commitment to improving the quality of care to the elderly,
the chronically ill and the disabled, or shall be persons who are
enrolled in a managed long term care plan or demonstration operating
under this section, or their representatives. No fewer than five of the
thirteen members shall be persons who are enrolled in a plan or
demonstration operating under this section, or their representatives. In
addition to the thirteen appointed members, the commissioner, the
superintendent of insurance and the director of the office for the aging
shall serve as non-voting ex-officio members of the advisory council.
(b) The council shall:
(i) review data and reports provided by the plans related to
demographic and clinical characteristics of enrollees, consumer
satisfaction and complaints, the number and reasons for voluntary and
involuntary disenrollments, service utilization and costs as compared to
fee-for-service;
(ii) review the managed long term care plans' progress on meeting
enrollment targets and their marketing practices;
(iii) evaluate the adequacy of plans' efforts to integrate health and
long term care services and benefit coordination;
(iv) advise the commissioner and the superintendent of insurance on
strategies to increase the private and public/private financing of such
plans;
(v) advise the commissioner and the superintendent of insurance on the
feasibility of increasing the caps on enrollment or the number of plans
that may be approved; and
(vi) review and comment on the reports prepared pursuant to
subdivision nine of this section.
11. The services provided or arranged by all operating demonstrations
may include, but need not be limited to, housing, inpatient and
outpatient hospital services, nursing home care, home health care, adult
day care, assisted living services provided in accordance with article
forty-six-B of this chapter, adult care facility services, enriched
housing program services, hospice care, respite care, personal care,
homemaker services, diagnostic laboratory services, therapeutic and
diagnostic radiologic services, emergency services, emergency alarm
systems, home delivered meals, physical adaptations to the client's
home, physician care (including consultant and referral services),
ancillary services, case management services, transportation, and
related medical services.
* NB Repealed December 31, 2015
Disclaimer: These codes may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
