ยง 4405. Health maintenance organizations; powers. The powers of health
maintenance organizations, in addition to any other powers conferred by
the laws under which such organization is constructed, shall include:
1. subject to the provisions of article twenty-eight of this chapter,
the purchase, lease, construction, renovation, operation, or maintenance
of hospitals, medical facilities, or both, and their ancillary
equipment, and such property as may reasonably be required for its
principal office or for such other purposes as may be necessary in the
transaction of the business of the organization;
2. the furnishing of comprehensive health care services on a prepaid
basis through hospitals and other health care providers which are under
contract with, otherwise associated with, or employed by the health
maintenance organization;
3. the marketing, enrollment and administration of a comprehensive
health services plan;
4. the contracting with an insurer licensed in this state;
5. the offering, in addition to health care services, of benefits
covering out-of-area or emergency services;
6. the provision of additional health services not included in the
comprehensive health services plan on a fee-for-service basis, the
provision of health services on a fee-for-service basis to persons who
are not members of the enrolled population;
7. the entering into contracts in furtherance of the purposes of this
article;
8. the acceptance from government agencies, private agencies,
corporations, associations, groups, individuals, or other persons,
payments covering all or part of the cost of health care services
provided to enrollees, in accordance with the provisions of the plan and
this chapter; and
9. the indemnification of enrollees for the services of health care
providers, other than primary care practitioners responsible for
supervising and coordinating the care of enrollees, not participating in
a plan to the extent authorized in section forty-four hundred six of
this article; and
10. notwithstanding any other provision of law, to advertise the
comprehensive health services which it renders and the plan relating to
the rendition of such services, provided, however, that all information
disseminated to the public shall be strictly factual in nature and
accurate in all respects and shall not in any way be misleading to the
public.
Structure New York Laws
Article 44 - Health Maintenance Organizations
4400 - Statement of Policy and Purposes.
4402 - Health Maintenance Organizations; Application for Certificate of Authority.
4403 - Health Maintenance Organizations; Issuance of Certificate of Authority.
4403-A - Special Purpose Certificate of Authority.
4403-B - Development of Comprehensive Health Services Plans.
4403-C - Comprehensive HIV Special Needs Plan Certification.
4403-D - Special Needs Managed Care Plans.
4403-E - Primary Care Partial Capitation Providers; Partial Capitation Certificate of Authority.
4403-F - Managed Long Term Care Plans.
4403-G - Developmental Disabilty Individual Support and Care Coordination Organizations.
4404 - Health Maintenance Organizations; Continuance of Certificate of Authority.
4405 - Health Maintenance Organizations; Powers.
4405-A - Immunizations Against Poliomyelitis, Mumps, Measles, Diphtheria and Rubella.
4406 - Health Maintenance Organizations; Regulation of Contracts.
4406-A - Arbitration Provisions of Health Maintenance Organization Contracts.
4406-B - Primary and Preventive Obstetric and Gynecologic Care.
4406-D - Health Care Professional Applications and Terminations.
4406-E - Access to End of Life Care.
4406-F - Maternal Depression Screenings.
4406-G - Telehealth Delivery of Services.
4406-H - Health Care Facility Applications.
4406-I - Utilization Review Determinations for Medically Fragile Children.
4407 - Health Maintenance Organizations; Employer Requirements.
4408 - Disclosure of Information.
4408-A - Integrated Delivery Systems.
4408-A*2 - Grievance Procedure.
4409 - Health Maintenance Organizations; Examinations.
4410 - Health Maintenance Organizations; Professional Services.
4414 - Health Care Compliance Programs.
4416 - Excess Reserves of Certain Health Maintenance Organizations.