(b) All rates of payments to hospitals, nursing homes, convalescent
institutions and instrumentalities providing home nursing services made
by such corporation pursuant to the contracts provided for in subsection
(a) hereof shall prior to payment, (i) in the case of institutions
subject to article twenty-eight of the public health law, be certified
by the commissioner of health pursuant to the provisions of such article
twenty-eight of the public health law and approved by the
superintendent, and, (ii) in the case of other institutions, approved as
to reasonableness by the superintendent.
(c) Notwithstanding subsections (a) and (b) of this section, approval
by the superintendent shall not be required for rates of payment by
article forty-three corporations for in-patient hospital services
provided after December thirty-first, nineteen hundred eighty-three by
general hospitals subject to article twenty-eight of the public health
law.
(d) After approval by the superintendent each corporation organized
under this article shall notify each hospital and health related service
of its approved rates of payment for out-patient services, in instances
where such rates are determined on the basis of a cost based formula, at
least thirty days prior to the beginning of each rate year.
* NB Expired January 1, 1986. Remains effective prior to such date.
See ch 906/85 ยง 3
Structure New York Laws
Article 43 - Non-Profit Medical and Dental Indemnity, or Health and Hospital Service Corporations
4301 - Organization of Corporation; Purposes; Board of Directors.
4302 - Permit and License to Do Business.
4303-A - Prescription Synchronization.
4306 - Required Contract Provisions.
4306-A - Health Insurance Coverage for Full-Time Students on Medical Leaves of Absence.
4306-B - Primary and Preventive Obstetric and Gynecologic Care.
4306-C - Grievance Procedure and Access to Specialty Care.
4306-D - Choice of Health Care Provider.
4306-E - Prohibition on Lifetime and Annual Limits.
4306-F - Maternal Depression Screenings.
4306-G - Telehealth Delivery of Services.
4306-H - Essential Health Benefits Package and Limit on Cost-Sharing.
4306-I - Coverage for Medically Fragile Children.
4308 - Supervision of Superintendent.
4309 - Limitation on Expenses.
4310 - Investments; Financial Conditions; Reserves.
4312 - Employment of Solicitors; Pension Plans.
4313 - Applicability of Other Provisions of This Chapter.
4314 - Not to Affect Provisions of Workers' Compensation Law.
4315 - Arbitration; Judicial Review.
4316 - Individual Contracts; Premium Refund at Death of Insured.
4317 - Rating of Individual and Small Group Health Insurance Contracts.
4318 - Pre-Existing Condition Provisions.
4318-A - Certification of Creditable Coverage by Corporations Organized Under This Article.
4320 - Limitations on Administrative Services and Stop-Loss Coverage.
4321-A - Fund for Standardized Individual Enrollee Direct Payment Contracts.
4324 - Disclosure of Information.
4326 - Standardized Health Insurance Contracts for Qualifying Small Employers and Individuals.