New York Laws
Article 44 - Health Maintenance Organizations
4404 - Health Maintenance Organizations; Continuance of Certificate of Authority.

§ 4404. Health maintenance organizations; continuance of certificate
of authority. 1. Continuance by the commissioner of a certificate of
authority issued under section forty-four hundred three of this article
shall be contingent upon satisfactory performance by the organization as
to the delivery, continuity, accessibility and quality of the services
to which an enrolled member is entitled, compliance with the provisions
of this article and rules and regulations promulgated thereunder, and
the continuing fiscal solvency of the organization as set out in this
section.

2. Except as provided in subdivision three of this section, the
commissioner may revoke, limit or annul a certificate of authority as of
the termination of the current period of all then existing enrollee
contracts, after a hearing, and only after a finding of unsatisfactory
performance or fiscal insolvency. However, in the event of such
revocation, limitation or annulment, the organization shall be
prohibited from entering into any new enrollee contracts as of the date
of notification of such action by the commissioner. Notification of such
action shall be given by the organization to each enrollee. The
commissioner shall give prior notice of such action to the
superintendent.

3. The commissioner may revoke or limit a certificate of authority,
after a hearing, for violations of any applicable statute or rules and
regulations which threatened to directly affect the health, safety or
welfare of any enrollee. Upon notice of his intent to revoke or limit a
certificate of authority, the commissioner may prohibit the organization
from entering into any new enrollee contracts pending final action and
may require notification of such action to be given by the organization
to each enrollee. The commissioner shall give prior notice to the
superintendent of his intent to prohibit the organization from entering
into any enrollee contracts. In any action pursuant to this subdivision,
the commissioner and the superintendent shall take action to assure the
continued insurance coverage of enrollees of the organization.

4. In addition to, or in lieu of, any revocation, limitation or
annulment, the commissioner may assess a penalty pursuant to section
twelve of this chapter for any violation of this chapter or rules and
regulations promulgated pursuant to this article.

5. All orders or determinations made in accordance with the provisions
of this section shall be subject to review as provided in article
seventy-eight of the civil practice law and rules. Application for such
review must be made within sixty days after service in person or by
registered mail of a copy of the order or determination upon the
organization.