* § 2807-j. Patient services payments. 1. Payments to designated\nproviders of services, as defined in paragraph (a) of subdivision one-a\nof this section, by all payors, including the state governmental\nagencies, corporations organized and operating in accordance with\narticle forty-three of the insurance law, organizations operating in\naccordance with the provisions of article forty-four of this chapter,\nlocal governmental agencies, self-insured funds, commercial insurers,\npayors pursuant to the comprehensive motor vehicle insurance reparations\nact, the workers' compensation law, the volunteer firefighters' benefit\nlaw and the volunteer ambulance workers' benefit law, and any other\nrate, charge, or negotiated payment payor, for patient services provided\nto persons who are not eligible for payments as beneficiaries of title\nXVIII of the federal social security act (medicare) shall include a\nsurcharge for an allowance on net patient service revenues in the\npercentage amount and for the periods specified in subdivision two of\nthis section. Any such allowance shall be submitted by or on behalf of\ndesignated providers of services to the commissioner or the\ncommissioner's designee in accordance with subdivision five of this\nsection.\n 1-a. Definitions. (a) "Designated providers of services", for purposes\nof this section, shall mean providers of services in the following\nclasses:\n (i) general hospitals;\n (ii) diagnostic and treatment centers that provide:\n (A) a comprehensive range of primary health care services; or\n (B) ambulatory surgical services; and\n (iii) for periods prior to October first, two thousand, subject to the\nprovisions of paragraph (d) of subdivision three of this section,\nfree-standing clinical laboratories issued a permit pursuant to title\nfive of article five of this chapter.\n (b) "Third-party coverage", for purposes of this section, shall\ninclude, but not be limited to: payments by a governmental agency,\ninsurer, health maintenance organization, self-insured fund, or other\nthird-party entity making payments on behalf of a patient; whether made\ndirectly to a designated provider of services or indirectly as indemnity\nor similar payments made to the patient (or patient's representative\nsuch as parent or family member) for services provided by a designated\nprovider of services, or through the use of payments made payable to\nboth the designated provider of services and the patient or patient's\nrepresentative, or similar devices.\n (c) "Third-party payors", for purposes of this section, shall include,\nbut not be limited to: governmental agencies; corporations organized and\noperating in accordance with article forty-three of the insurance law;\norganizations operating in accordance with the provisions of article\nforty-four of this chapter; providers of coverage pursuant to the\ncomprehensive motor vehicle insurance reparations act, the workers'\ncompensation law, the volunteer firefighters' benefit law, and the\nvolunteer ambulance workers' benefit law; self-insured funds and\nadministrators acting on behalf of self-insured funds; and commercial\ninsurers licensed to do business in this state and authorized to write\naccident and health insurance and whose policy provides coverage on an\nexpense incurred basis.\n 2. (a) The total percentage allowance for any period during the period\nJanuary first, nineteen hundred ninety-seven through December\nthirty-first, nineteen hundred ninety-nine and on and after January\nfirst, two thousand, for a designated provider of services applicable to\na payor shall be determined in accordance with this subdivision and\napplied to net patient service revenues.\n (b) The total percentage allowance for each payor, other than\ngovernmental agencies, or health maintenance organizations for services\nprovided to subscribers eligible for medical assistance pursuant to\ntitle eleven of article five of the social services law, or approved\norga
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