§ 2959-a. Multipayor patient centered medical home program. 1. (a) The\ncommissioner is authorized to establish medical home multipayor programs\n(referred to in this section as a "program") whereby enhanced payments\nare made to primary care clinicians and clinics statewide that are\ncertified as medical homes for the purpose of improving health care\noutcomes and efficiency through improved access, patient care continuity\nand coordination of health services.\n (b) As used in this section:\n (i) "clinic" means a general hospital providing outpatient care or\ndiagnostic and treatment center, licensed under article twenty-eight of\nthis chapter; and\n (ii) "primary care clinician" means a physician, nurse practitioner,\nor midwife acting within his or her lawful scope of practice under title\neight of the education law and who is practicing in a primary care\nspecialty.\n (iii) "primary care medical home collaborative" means an entity\napproved by the commissioner which shall include but not be limited to\nhealth care providers, which may include but not be limited to\nhospitals, diagnostic and treatment centers, private practices and\nindependent practice associations, and payors of health care services,\nwhich may include but not be limited to employers, health plans and\ninsurers.\n 2. (a) In order to promote improved quality of, and access to, health\ncare services and promote improved clinical outcomes, it is the policy\nof the state to encourage cooperative, collaborative and integrative\narrangements among payors of health care services and health care\nservices providers who might otherwise be competitors, under the active\nsupervision of the commissioner. It is the intent of the state to\nsupplant competition with such arrangements and regulation only to the\nextent necessary to accomplish the purposes of this article, and to\nprovide state action immunity under the state and federal antitrust laws\nto payors of health care services and health care services providers\nwith respect to the planning, implementation and operation of the\nmultipayor patient centered medical home program.\n (b) The commissioner or his or her duly authorized representative may\nengage in appropriate state supervision necessary to promote state\naction immunity under the state and federal antitrust laws, and may\ninspect or request additional documentation from payors of health care\nservices and health care services providers to verify that medical homes\ncertified pursuant to this section operate in accordance with its intent\nand purpose.\n 3. The commissioner is authorized to participate in, actively\nsupervise, facilitate and approve a primary care medical home\ncollaborative for each program around the state to establish: (a) the\nboundaries of each program and the providers eligible to participate,\nprovided that the boundaries of programs may overlap; (b) practice\nstandards for each medical home program adopted with consideration of\nexisting standards developed by the National Committee for Quality\nAssurance ("NCQA"), the Joint Commission of Accreditation of Healthcare\nOrganizations ("JCAHCO" or the "Joint Commission"), American\nAccreditation Healthcare Commission ("URAC"), American College of\nPhysicians, the American Academy of Family Physicians, the American\nAcademy of Pediatrics, and the American Osteopathic Association; the\nAmerican Academy of Nurse Practitioners, and the American College of\nNurse Practitioners; (c) standards for implementation and use of health\ninformation technology, including participation in health information\nexchanges through the statewide health information network; (d)\nmethodologies by which payors will provide enhanced rates of payment to\ncertified medical homes; (e) requirements for collecting data relating\nto the providing and paying for health care services under the program\nand providing of data to the commissioner, payors and health care\nproviders under the program, to promote ‹ Prev All New York sections Next ›
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