New York Insurance Code § 4301

Organization of corporation; purposes; board of directors
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§ 4301. Organization of corporation; purposes; board of directors. (a)\nA corporation may be organized under the not-for-profit corporation law,\nand a consumers' cooperative stock corporation may be organized under\narticle two of the cooperative corporations law, for the purpose of\nfurnishing medical expense indemnity, dental expense indemnity, hospital\nservice, or health service or, upon compliance with the applicable\nprovisions of subsection (h) of this section, both medical expense\nindemnity and hospital service, to persons who become covered under\ncontracts with such corporations.\n  (b) (1) Medical expense indemnity shall consist of reimbursement for:\n  (A) medical care provided through licensed physicians,\n  (B) dental care provided through licensed dentists,\n  (C) optometric care provided through licensed optometrists,\n  (D) podiatrical care provided through licensed podiatrists,\n  (E) chiropractic care provided through licensed chiropractors,\n  (F) psychiatric or psychological services provided through physicians,\npsychiatrists or certified and registered psychologists,\n  (G) physical and occupational therapy care provided through licensed\nphysical and occupational therapists upon the prescription of a\nphysician,\n  (H) nursing service,\n  (I) speech-language pathology or audiology services provided through\nlicensed speech-language pathologists or audiologists, provided however,\nthat nothing contained herein shall be construed to prohibit a contract\nfrom requiring said service from being performed pursuant to a medical\norder or similar or related service of a physician, in which case\ncoverage need not be provided for any tests, evaluations or diagnoses if\nsuch tests, evaluations or diagnoses have already been provided by or\nthrough a physician within twelve months of the referral or order from\nthe physician. However, nothing herein shall be construed as preventing\na corporation from covering more than one test or evaluation provided by\na speech-language pathologist or audiologist within a twelve-month\nperiod where such tests or evaluations is ordered by a physician as\nmedically necessary. Nor shall anything herein be construed as\nprohibiting the limitation of such services, where covered, to specified\nsettings other than offices, such as hospitals or to services provided\nby such professionals as part of a home care agency's services,\n  (J) necessary appliances, drugs, medicines and supplies, and\n  (K) bio-analytical or clinical laboratory examinations and reports\nthereof reported to a physician, osteopath, dentist, optometrist,\npodiatrist, chiropractor or physical therapist made by any privately\noperated bioanalytical or clinical laboratory.\n  (2) It is not mandatory that a contract issued by a medical expense\nindemnity corporation provide for and offer all of the services\nhereinabove described, but when any service is provided which can be\nperformed by more than one of the practitioners hereinbefore referred\nto, benefits under the contract shall be provided regardless of which\npractitioner performed the service, provided that the performance of\nsuch service was within the scope of the license of such practitioner.\nUnless such contract shall otherwise provide there shall be no\nreimbursement for ophthalmic materials, lenses, spectacles, eyeglasses,\nand/or appurtenances thereto.\n  (3) Every medical expense indemnity corporation shall be open to the\nparticipation of licensed physicians, podiatrists, chiropractors,\noptometrists, physical and occupational therapists, speech-language\npathologists, audiologists, and dentists, certified and registered\npsychologists without discrimination against schools of medical\npractice, podiatry practice, chiropractic practice, optometric practice,\nphysical and occupational therapy practice, dental practice,\nspeech-language pathology practice (subject to the permitted limitations\nof paragraph one of this subsection), audiology practic

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