A06019 Summary:

BILL NOA06019
 
SAME ASNo Same As
 
SPONSORPaulin (MS)
 
COSPNSRColton, Magnarelli, Bronson, Rosenthal L, Thiele, Benedetto, Peoples-Stokes, Gunther, Weprin, Otis, Aubry, Stirpe, Steck, Hunter, Zebrowski, Hevesi, Simon, Rozic, Jean-Pierre, Taylor, Lavine, Sayegh, Seawright, Reyes, Levenberg, Shrestha
 
MLTSPNSRBraunstein, Carroll, Cook, DeStefano, Dinowitz, Fahy, Glick, Lupardo, McDonough, Pretlow, Ra
 
Add Art 49 Title III §§4920 - 4929, Pub Health L
 
Enacts provisions relating to collective negotiations by health care providers with certain health care plans in certain counties; applies to health benefit plans that provide benefits for medical or surgical expenses incurred as a result of a health condition, accident or sickness, including an individual, group, blanket or franchise insurance policy or insurance agreement offered by certain enumerated entities.
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A06019 Actions:

BILL NOA06019
 
03/30/2023referred to health
05/23/2023reported referred to codes
01/03/2024referred to codes
03/19/2024reported referred to ways and means
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A06019 Committee Votes:

HEALTH Chair:Paulin DATE:05/23/2023AYE/NAY:18/8 Action: Favorable refer to committee Codes
PaulinAyeJensenNay
DinowitzAyeByrnesNay
GuntherAyeGandolfoNay
Rosenthal L AyeMikulinNay
HevesiAyeBlumencranzNay
SteckAyeBendettNay
BraunsteinAyeGrayNay
SolagesAyeMcGowanNay
Bichotte HermelAye
SayeghAye
Rosenthal D Aye
McDonaldAye
ReyesAye
Gonzalez-RojasAye
RajkumarAye
ForrestAye
KellesAye
LucasAye

CODES Chair:Dinowitz DATE:03/19/2024AYE/NAY:16/5 Action: Favorable refer to committee Ways and Means
DinowitzAyeMorinelloNay
PretlowAyeReillyAye
CookAyeMikulinNay
LavineAyeTannousisAye
WeprinAyeCurranNay
HevesiAyeAngelinoNay
SeawrightAyeFloodNay
RosenthalAye
WalkerAbsent
VanelAye
CruzAye
CarrollAye
SimonAye
EpsteinAye
BoresAye

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A06019 Floor Votes:

There are no votes for this bill in this legislative session.
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A06019 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A6019
 
SPONSOR: Paulin (MS)
  TITLE OF BILL: An act to amend the public health law, in relation to requirements for collective negotiations by health care providers with certain health benefit plans   PURPOSE OR GENERAL IDEA OF BILL: This bill is designed to restore fairness in the contracting process between physicians and large managed care plans by allowing doctors to join together to negotiate contract provisions. This legislation would not authorize strikes of health benefit plans by physicians.   SUMMARY OF SPECIFIC PROVISIONS: Section 1 is a statement of legislative intent that states that the Legislature finds it appropriate and necessary to authorize collective negotiations on patient care issues and on fee-related and other issues, where it determines that health plans have an undue advantage negotiat- ing the terms of contracts with health care providers. The legislative intent clarifies that the act is not intended to apply or affect collec- tive bargaining relationships involving health care providers who are employees of health care providers or rights relating to collective bargaining arising under applicable federal/state collective bargaining statutes. Section 2 cites the bill as the Health Care Consumer and Provider Protection Act. Section 3 amends article 49 to the public health law by adding a new title III titled Collective Negotiations by Health Care Providers with Health Care Plans. This legislation adds a new Article 49-A to the public health law to authorize collective bargaining for independent contractor health care providers including physicians or an entity that employs or utilizes health care providers to provide health care services. This bill would create a system under which the state would closely monitor those nego- tiations, and any negotiations involving fee-related matters would only be permitted when an individual managed care plan controls a substantial share of the managed care market. The Commissioner of Health would be authorized to approve the health care providers'-.representative request to negotiate based upon the benefits to be achieved for providers and consumers of health services and is required to review any offer submit- ted to the health care providers' . representative prior to sharing with affected health care providers. The legislation would also create a mechanism for resolving disputes when there is an impasse or when the health plan refuses to negotiate. The bill would also direct the Commis- sioner of Health to approve any final agreement as wells monitor the implemented agreements to ensure continued compliance with the law. Importantly, this legislation would not authorize strikes or concerted action by physicians in response to negotiations with health care plans. Section 4 is the effective date.   JUSTIFICATION: Currently, federal antitrust laws prohibit individual physicians from collectively negotiating any provisions of contracts they sign with managed care entities. This bill would allow physicians in New York State to conduct some collective negotiations by creating a system under which the state would closely monitor those negotiations, facilitate resolution of negotiation impasses, and actively monitor implementation of agreements. Negotiations involving fee-related matters would be prohibited unless an individual managed care plan controls a substantial share of the managed care market. Giving physicians greater ability to advocate for patients in contract negotiations is critical since large health maintenance organizations control huge shares of the health insurance market, both in New York and across the country. In recent years we have seen the mergers of United Healthcare and Oxford, MVP and Preferred Care, and Wellpoint with Well- choice (Empire). As of March 2008, almost 75% of the enrollees in managed care plans in New York State were enrolled in just five health plans (GHWHIP, United/Oxford/Americhoice, Excellus, Empire and MVP/Preferred Care). We have also seen an emerging trend of long-time not-for-profit health insurance companies such as Empire and HIP seeking to convert to for-profit status. Due to the current imbalance of-negotiating power in favor of the managed care plans, physicians and other health care providers are offered take-it-or-leave-it contracts by health plans that significantly hamper their ability to provide quality patient care. These contracts permit burdensome processes and unjustifiably long wait times for obtaining pre-authorization to provide needed patient care; impose limi- tations on whom a physician may refer a patient for necessary care; permit demands for refunds of payments long after the time that such payments were originally made; permit health plans to make major changes to key elements of a contract without physician consent; and cede to physicians the legal consequences for patients harmed by health plan utilization review decisions. This bill, by allowing independent contractor physicians to conduct some collective negotiations while being closely monitored by the state, would give physicians greater ability to-advocate for patients in contract negotiations. This bill would create a system under which the state would closely monitor those negotiations, and any negotiations involving fee-related matters would only be permitted when an individual Managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.   PRIOR LEGISLATIVE HISTORY: 2000: A.9484A - Referred to Health 2001-2002: A.5466 - Reported to Third Reading Calendar 2003-2004: A.1317A - Reported to Ways and Means 2005-2006: A.6458 - Reported to Ways and.Means 2007-2008: A.2177 - Reported to Ways and Means 2009-2010: A.4301B- Reported to Ways and Means 2011-2012: A.2474B - Reported to Ways and Means 2013-2014: A.5692 - Reported to Ways and Means 2015-2016: A.33.6A - Reported to Ways and Means 2017-2018: A.4472 - Reported to Ways and Means 2019-2020: A.2393 - Reported to Ways and Means 2021-2022: A.951 - Referred to Health   FISCAL IMPLICATIONS: None to the State. The bill would provide the legal basis for an appro- priation of funds to implement the provisions of the bill.   EFFECTIVE DATE: 120 days after it shall have become a law, provided that the department of health may promulgate and establish any regulations pursuant hereto prior to the effective date.
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A06019 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          6019
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                     March 30, 2023
                                       ___________
 
        Introduced  by  M.  of A. PAULIN, COLTON, MAGNARELLI, BRONSON, L. ROSEN-
          THAL, THIELE, BENEDETTO, PEOPLES-STOKES, GUNTHER, WEPRIN, OTIS, AUBRY,
          STIRPE, STECK, HUNTER, ZEBROWSKI, HEVESI, SIMON,  ROZIC,  JEAN-PIERRE,
          TAYLOR,  LAVINE,  SAYEGH, SEAWRIGHT, REYES -- Multi-Sponsored by -- M.
          of A. BRAUNSTEIN, CARROLL, COOK,  DeSTEFANO,  DINOWITZ,  FAHY,  GLICK,
          LUPARDO,  McDONOUGH,  PRETLOW,  RA  --  read  once and referred to the
          Committee on Health
 
        AN ACT to amend the public health law, in relation to  requirements  for
          collective  negotiations  by health care providers with certain health
          benefit plans
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section 1. Statement of legislative intent. The legislature finds that
     2  collective  negotiation by competing health care providers for the terms
     3  and conditions of contracts with health plans can result  in  beneficial
     4  results  for  health  care  consumers.  The  legislature  further  finds
     5  instances where health plans dominate the market to such a  degree  that
     6  fair  and  adequate  negotiations  between health care providers and the
     7  plans are adversely affected, so that it is necessary and appropriate to
     8  provide for a system of collective  action  on  behalf  of  health  care
     9  providers. Consequently, the legislature finds it appropriate and neces-
    10  sary  to  displace  competition  with regulation of health plan-provider
    11  agreements and authorize collective negotiations on the terms and condi-
    12  tions of the relationship between health  care  plans  and  health  care
    13  providers  so  the imbalances between the two will not result in adverse
    14  conditions of health care. This act is  not  intended  to  apply  to  or
    15  affect  in  any  respect collective bargaining relationships which arise
    16  under applicable federal or state collective bargaining statutes.
    17    § 2. This act shall be known and may be  cited  as  the  "health  care
    18  consumer and provider protection act".

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08052-01-3

        A. 6019                             2
 
     1    §  3.  Article  49 of the public health law is amended by adding a new
     2  title III to read as follows:
     3                                  TITLE III
     4                   COLLECTIVE NEGOTIATIONS BY HEALTH CARE
     5                      PROVIDERS WITH HEALTH CARE PLANS
     6  Section 4920. Definitions.
     7          4921. Non-fee related collective negotiation authorized.
     8          4922. Fee related collective negotiation.
     9          4923. Collective negotiation requirements.
    10          4924. Requirements for health care providers' representative.
    11          4925. Certain collective action prohibited.
    12          4926. Fees.
    13          4927. Monitoring of agreements.
    14          4928. Confidentiality.
    15          4929. Severability and construction.
    16    § 4920. Definitions. For purposes of this title:
    17    1.  "Health  care  plan"  means  an  entity  (other than a health care
    18  provider) that approves, provides, arranges for, or pays for health care
    19  services, including but not limited to:
    20    (a) a health maintenance organization  licensed  pursuant  to  article
    21  forty-three  of  the  insurance  law  or  certified  pursuant to article
    22  forty-four of this chapter;
    23    (b) any other organization certified pursuant to article forty-four of
    24  this chapter; or
    25    (c) an insurer or corporation subject to the insurance law.
    26    2. "Person" means an  individual,  association,  corporation,  or  any
    27  other legal entity.
    28    3.  "Health care providers' representative" means a third party who is
    29  authorized by health care providers to negotiate on  their  behalf  with
    30  health  care plans over contractual terms and conditions affecting those
    31  health care providers.
    32    4. "Strike" means a work stoppage in part or in whole, direct or indi-
    33  rect, by a health care provider or health care providers to gain compli-
    34  ance with demands made on a health care plan.
    35    5. "Substantial market share in a business line" exists  if  a  health
    36  care  plan's  market share of a business line within the geographic area
    37  for which a negotiation has been approved by the commissioner, alone  or
    38  in  combination with the market shares of affiliates, exceeds either ten
    39  percent of the total number of covered lives in that  service  area  for
    40  such business line or twenty-five thousand lives, or if the commissioner
    41  determines  the  market  share  of the insurer in the relevant insurance
    42  product and geographic markets for the services of the providers seeking
    43  to  collectively  negotiate  significantly  exceeds  the  countervailing
    44  market share of the providers acting individually.
    45    6.  "Health  care provider" means a person who is licensed, certified,
    46  registered or authorized pursuant to title eight of  the  education  law
    47  and  who practices that profession as a health care provider as an inde-
    48  pendent contractor and/or who is  an  owner,  officer,  shareholder,  or
    49  proprietor  of  a  health  care  provider,  or an entity that employs or
    50  utilizes health care providers to provide health care services,  includ-
    51  ing but not limited to a hospital licensed under article twenty-eight of
    52  this  chapter  or an accountable care organization under article twenty-
    53  nine-E of this chapter; or an entity authorized under  articles  thirty-
    54  six  or forty of this chapter; or a fiscal intermediary operating pursu-
    55  ant to section three hundred sixty-five-f of the social services law.  A
    56  health care provider under title eight of the education  law  who  prac-

        A. 6019                             3
 
     1  tices  as  an  employee  of a health care provider shall not be deemed a
     2  health care provider for purposes of this title.
     3    §  4921.  Non-fee related collective negotiation authorized. 1. Health
     4  care providers practicing within the geographic area for which a negoti-
     5  ation has been approved by the commissioner may meet and communicate for
     6  the purpose of collectively negotiating the following terms  and  condi-
     7  tions of provider contracts with the health care plan:
     8    (a)  the details of the utilization review plan as defined pursuant to
     9  subdivision ten of  section  forty-nine  hundred  of  this  article  and
    10  subsection  (j)  of  section four thousand nine hundred of the insurance
    11  law;
    12    (b) coverage  provisions;  health  care  benefits;  benefit  maximums,
    13  including benefit limitations; and exclusions of coverage;
    14    (c) the definition of medical necessity;
    15    (d)  the  clinical  practice guidelines used to make medical necessity
    16  and utilization review determinations;
    17    (e) preventive care and other medical management practices;
    18    (f) drug formularies and  standards  and  procedures  for  prescribing
    19  off-formulary drugs;
    20    (g) respective physician liability for the treatment or lack of treat-
    21  ment of covered persons;
    22    (h)  the  details  of health care plan risk transfer arrangements with
    23  providers;
    24    (i) plan administrative procedures, including methods  and  timing  of
    25  health care provider payment for services;
    26    (j)  procedures  to be utilized to resolve disputes between the health
    27  care plan and health care providers;
    28    (k) patient referral procedures including, but not limited  to,  those
    29  applicable to out-of-network referrals;
    30    (l) the formulation and application of health care provider reimburse-
    31  ment procedures;
    32    (m) quality assurance programs;
    33    (n)  the  process  for  rendering  utilization  review  determinations
    34  including: establishment of a process for rendering  utilization  review
    35  determinations which shall, at a minimum, include: written procedures to
    36  assure  that utilization reviews and determinations are conducted within
    37  the timeframes established in this  article;  procedures  to  notify  an
    38  enrollee,  an  enrollee's  designee  and/or  an  enrollee's  health care
    39  provider of adverse determinations; and procedures for appeal of adverse
    40  determinations, including the  establishment  of  an  expedited  appeals
    41  process  for denials of continued inpatient care or where there is immi-
    42  nent or serious threat to the health of the enrollee; and
    43    (o) health care provider selection and termination  criteria  used  by
    44  the health care plan.
    45    2. Nothing in this section shall be construed to allow or authorize an
    46  alteration  of  the terms of the internal and external review procedures
    47  set forth in law.
    48    3. Nothing in this section shall be construed to allow a strike  of  a
    49  health  care  plan  by  health  care providers or plans as otherwise set
    50  forth in the laws of this state.
    51    4. Nothing in this section shall be construed to  allow  or  authorize
    52  terms or conditions which would impede the ability of a health care plan
    53  to  obtain or retain accreditation by the national committee for quality
    54  assurance or a similar body.
    55    § 4922. Fee related collective negotiation. 1. If the health care plan
    56  has substantial market share in a business line in any  geographic  area

        A. 6019                             4

     1  for  which  a  negotiation has been approved by the commissioner, health
     2  care providers practicing within that geographic area  may  collectively
     3  negotiate  the  following terms and conditions relating to that business
     4  line with the health care plan:
     5    (a)  the fees assessed by the health care plan for services, including
     6  fees established through the application of reimbursement procedures;
     7    (b) the  conversion  factors  used  by  the  health  care  plan  in  a
     8  resource-based  relative  value scale reimbursement methodology or other
     9  similar methodology; provided the same are not otherwise established  by
    10  state or federal law or regulation;
    11    (c)  the amount of any discount granted by the health care plan on the
    12  fee of health care services to be rendered by health care providers;
    13    (d) the dollar amount  of  capitation  or  fixed  payment  for  health
    14  services  rendered  by  health care providers to health care plan enrol-
    15  lees;
    16    (e) the procedure code or other description of a health  care  service
    17  covered  by  a  payment  and  the  appropriate grouping of the procedure
    18  codes; or
    19    (f) the amount of any other component of the reimbursement methodology
    20  for a health care service.
    21    2. Nothing herein shall be deemed to affect or limit the  right  of  a
    22  health  care  provider or group of health care providers to collectively
    23  petition a government entity for a change in a law, rule, or regulation.
    24    § 4923. Collective negotiation requirements. 1. Collective negotiation
    25  rights granted by this title must conform to the following requirements:
    26    (a) health care providers  may  communicate  with  other  health  care
    27  providers  regarding  the contractual terms and conditions to be negoti-
    28  ated with a health care plan;
    29    (b) health care providers may communicate with health care  providers'
    30  representatives;
    31    (c)  a health care providers' representative is the only party author-
    32  ized to negotiate with health care plans on behalf of  the  health  care
    33  providers as a group;
    34    (d)  a  health  care provider can be bound by the terms and conditions
    35  negotiated by the health care providers' representatives; and
    36    (e) in communicating or negotiating with the  health  care  providers'
    37  representative, a health care plan is entitled to contract with or offer
    38  different  contract  terms and conditions to individual competing health
    39  care providers.
    40    2. A health care providers' representative may not represent more than
    41  thirty percent of the market of health care providers or of a particular
    42  health care provider type or specialty practicing in the geographic area
    43  for which a negotiation has been approved by  the  commissioner  if  the
    44  health  care  plan covers less than five percent of the actual number of
    45  covered lives of the health care plan in the area, as determined by  the
    46  department.
    47    3.  Nothing  in this section shall be construed to prohibit collective
    48  action on the part of any health care provider who  is  a  member  of  a
    49  collective  bargaining  unit  recognized  pursuant to the national labor
    50  relations act.
    51    § 4924. Requirements for health  care  providers'  representative.  1.
    52  Before  engaging  in  collective negotiations with a health care plan on
    53  behalf of health care providers, a health care providers' representative
    54  shall file with the  commissioner,  in  the  manner  prescribed  by  the
    55  commissioner,  information identifying the representative, the represen-

        A. 6019                             5
 
     1  tative's plan of  operation,  and  the  representative's  procedures  to
     2  ensure compliance with this title.
     3    2.  Before  engaging  in  the collective negotiations, the health care
     4  providers' representative shall also submit to the commissioner for  the
     5  commissioner's approval a report identifying the proposed subject matter
     6  of  the  negotiations  or  discussions with the health care plan and the
     7  efficiencies or benefits expected to be  achieved  through  the  negoti-
     8  ations  for  both  the  providers  and consumers of health services. The
     9  commissioner shall not  approve  the  report  if  the  commissioner,  in
    10  consultation  with  the  superintendent of financial services determines
    11  that the proposed negotiations would exceed the authority granted  under
    12  this title.
    13    3.  The  representative shall supplement the information in the report
    14  on a regular basis or as new information becomes  available,  indicating
    15  that  the  subject  matter of the negotiations with the health care plan
    16  has changed or will change. In no event shall the report  be  less  than
    17  every thirty days.
    18    4. With the advice of the superintendent of financial services and the
    19  attorney  general,  the  commissioner  shall  approve  or disapprove the
    20  report not later than the twentieth day after  the  date  on  which  the
    21  report  is filed. If disapproved, the commissioner shall furnish a writ-
    22  ten explanation of any deficiencies, along with a statement of  specific
    23  proposals for remedial measures to cure the deficiencies. If the commis-
    24  sioner  does  not  so  act  within  the twenty days, the report shall be
    25  deemed approved.
    26    5. A person who acts as a health care providers' representative  with-
    27  out  the approval of the commissioner under this section shall be deemed
    28  to be acting outside the authority granted under this title.
    29    6. Before reporting the results of negotiations  with  a  health  care
    30  plan or providing to the affected health care providers an evaluation of
    31  any  offer made by a health care plan, the health care providers' repre-
    32  sentative shall furnish for approval by the commissioner, before dissem-
    33  ination to the health care providers, a copy of all communications to be
    34  made to the health care providers related to negotiations,  discussions,
    35  and offers made by the health care plan.
    36    7.  A  health  care providers' representative  shall report the end of
    37  negotiations to the commissioner not later than the fourteenth day after
    38  the date of a health care plan decision declining negotiation, canceling
    39  negotiations, or failing to respond to a request for  negotiation.    In
    40  such  instances,  a  health  care  providers' representative may request
    41  intervention from the commissioner to require the health  care  plan  to
    42  participate  in  the  negotiation  pursuant to subdivision eight of this
    43  section.
    44    8. (a) In the event the commissioner determines that an impasse exists
    45  in the negotiations, or in the event a  health  care  plan  declines  to
    46  negotiate,  cancels  negotiations  or  fails to respond to a request for
    47  negotiation, the commissioner shall render assistance as follows:
    48    (1) to assist the parties to effect  a  voluntary  resolution  of  the
    49  negotiations,  the  commissioner shall appoint a mediator from a list of
    50  qualified persons maintained by the commissioner.  If  the  mediator  is
    51  successful  in  resolving  the  impasse, then the health care providers'
    52  representative shall proceed as set forth in this article;
    53    (2) if an impasse continues, the commissioner shall  appoint  a  fact-
    54  finding  board  of  not more than three members from a list of qualified
    55  persons maintained by the commissioner, which fact-finding  board  shall

        A. 6019                             6
 
     1  have,  in addition to the powers delegated to it by the board, the power
     2  to make recommendations for the resolution of the dispute;
     3    (b) The fact-finding board, acting by a majority of its members, shall
     4  transmit  its findings of fact and recommendations for resolution of the
     5  dispute to the commissioner, and may thereafter assist  the  parties  to
     6  effect  a  voluntary  resolution  of the dispute. The fact-finding board
     7  shall also share its findings  of  fact  and  recommendations  with  the
     8  health care providers' representative and the health care plan. If with-
     9  in  twenty  days after the submission of the findings of fact and recom-
    10  mendations, the impasse continues, the commissioner shall order a resol-
    11  ution  to  the  negotiations  based  upon  the  findings  of  fact   and
    12  recommendations submitted by the fact-finding board.
    13    9.  Any  proposed agreement between health care providers and a health
    14  care plan negotiated pursuant to this title shall be  submitted  to  the
    15  commissioner  for  final  approval.  The  commissioner  shall approve or
    16  disapprove the agreement within sixty days of such submission.
    17    10. The commissioner may collect information  from  other  persons  to
    18  assist  in  evaluating  the  impact  of  the proposed arrangement on the
    19  health care marketplace. The commissioner shall collect information from
    20  health plan companies and health care providers operating  in  the  same
    21  geographic area.
    22    §  4925.  Certain  collective  action prohibited. 1. This title is not
    23  intended to authorize competing health care providers to act in  concert
    24  in  response  to a report issued by the health care providers' represen-
    25  tative related to the representative's discussions or negotiations  with
    26  health care plans.
    27    2. No health care providers' representative shall negotiate any agree-
    28  ment  that  excludes,  limits  the participation or reimbursement of, or
    29  otherwise limits the scope of services to be provided by any health care
    30  provider or group of health care providers with respect to the  perform-
    31  ance  of  services  that  are within the health care provider's scope of
    32  practice, license, registration, or certificate.
    33    § 4926. Fees. Each person who acts as the representative or  negotiat-
    34  ing parties under this title shall pay to the department a fee to act as
    35  a  representative.  The commissioner, by rule, shall set fees in amounts
    36  deemed reasonable and necessary to  cover  the  costs  incurred  by  the
    37  department  in  administering  this  title. Any fee collected under this
    38  section shall be deposited in the state treasury to the  credit  of  the
    39  general fund/state operations - 003 for the New York state department of
    40  health fund.
    41    §  4927.  Monitoring  of  agreements.  The commissioner shall actively
    42  monitor agreements approved under this title to ensure that  the  agree-
    43  ment  remains  in  compliance  with  the  conditions  of  approval. Upon
    44  request, a health care plan or health care provider shall provide infor-
    45  mation regarding compliance. The commissioner  may  revoke  an  approval
    46  upon  a finding that the agreement is not in substantial compliance with
    47  the terms of the application or the conditions of approval.
    48    § 4928. Confidentiality. All reports and other information required to
    49  be reported to the department of law under this title including informa-
    50  tion obtained by the commissioner pursuant to subdivision ten of section
    51  forty-nine hundred twenty-four of this title shall  not  be  subject  to
    52  disclosure under article six of the public officers law or article thir-
    53  ty-one of the civil practice law and rules.
    54    §  4929.  Severability  and construction. The provisions of this title
    55  shall be severable, and if any court of competent jurisdiction  declares
    56  any  phrase,  clause, sentence or provision of this title to be invalid,

        A. 6019                             7
 
     1  or its applicability to any government, agency, person  or  circumstance
     2  is declared invalid, the remainder of this title and its relevant appli-
     3  cability  shall  not  be affected. The provisions of this title shall be
     4  liberally construed to give effect to the purposes thereof.
     5    § 4. This act shall take effect on the one hundred twentieth day after
     6  it  shall have become a law; provided that the commissioner of health is
     7  authorized to promulgate any and all rules and regulations and take  any
     8  other  measures necessary to implement this act on its effective date on
     9  or before such date.
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