* § 4408-a. Integrated delivery systems. 1. Legislative purpose and\nfindings. The legislature intends to facilitate the ability of\nintegrated delivery systems to assume a larger role in delivering a full\narray of health care services, from primary and preventive care through\nacute inpatient hospital and post-hospital care to a defined population\nfor a determined price. The legislature finds that the formation and\noperation of integrated delivery systems under this section will promote\nthe purposes of federal and state anti-referral statutes which are to\nreduce over-utilization and expenditures and finds that such statutes\nshould not be interpreted to interfere with the development of such\nintegrated delivery systems or impose liability for arrangements between\nan integrated delivery system certified pursuant to this section and its\nparticipating providers and entities. The legislature further finds that\nthe development of integrated delivery systems will reduce costs and\nenhance quality. It intends that systems acting pursuant to a\ncertificate of authority issued under this section shall not be subject\nto state or federal antitrust liability for doing so.\n 2. Definitions. For the purposes of this section:\n (a) "Applicant" means a separate legal entity created for the purpose\nof establishing and operating an integrated delivery system. Such entity\nshall be composed of or controlled by one or more affiliated providers\nor one or more affiliated groups of providers.\n (b) "Provider" means an entity licensed or certified under article\ntwenty-eight or thirty-six of this chapter; an entity licensed or\ncertified under article sixteen, twenty-three, thirty-one or thirty-two\nof the mental hygiene law; or a health care practitioner, or combination\nof health care practitioners, licensed under title eight of the\neducation law. Every provider shall be: (i) a natural person; (ii) a\npartnership all of whose members are natural persons and that is not a\nlimited partnership; or (iii) a corporation none of whose stock is owned\nby another corporation.\n 3. The commissioner, after receiving from the superintendent of\nfinancial services the evaluations and approvals required pursuant to\nsubdivision seven of this section, may issue a certificate of authority\nto an applicant which satisfies the conditions under this section for\nissuance established by the commissioner and which seeks to deliver\ncomprehensive health services, on a capitated basis, including inpatient\nservices, to:\n (a) persons who are receiving benefits under title XVIII of the\nfederal social security act; or\n (b) persons who are receiving benefits under title XIX of the federal\nsocial security act and commercial enrollees; or\n (c) an enrollee population which includes persons receiving benefits\nunder titles XVIII and XIX of the federal social security act and\ncommercial enrollees.\n 4. An applicant must demonstrate to the commissioner that it will\nprovide at least seventy-five percent of the total expenditures for\ncovered health care items and services directly to its enrollees through\nthe provider, affiliated providers or affiliated groups of providers\ncomprising such applicant. The applicant shall make arrangements or\nreferrals for any covered health care items and services not provided\ndirectly to its enrollees by such applicant.\n 5. A provider shall be deemed affiliated with another provider or\ngroup of providers if, through contract, ownership or otherwise:\n (a) one provider, directly or indirectly, owns, controls, or holds the\npower to vote, or proxies for, not less than fifty-one percent of the\nvoting rights or governance rights of another;\n (b) each provider is a participant in a lawful combination under which\neach provider shares, either directly or indirectly, substantial\nfinancial risk in connection with the activities and services of such\ncombination; or\n (c) a provider is a corporate member of a provid
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