§ 2999-O — Definitions

New York § 2999-O

• Jurisdiction: New York
• Law PBH: Public Health
• Art. 29-E: Accountable Care Organizations

Text

§ 2999-o. Definitions. As used in this article, the following terms\nshall have the following meanings, unless the context clearly requires\notherwise:\n 1. "Accountable care organization" or "ACO" means an organization of\nclinically integrated health care providers certified by the\ncommissioner under this article.\n 2. "ACO participant" or "participant" means a health care provider\nthat is one of the health care providers that comprise the ACO.\n 3. Certificate of authority" or "certificate" means a certificate of\nauthority issued by the commissioner under this article.\n 4. "CMS" means the federal centers for Medicare and Medicaid services.\n 5. "CMS regulations" means applicable federal laws and CMS regulations\nand policies.\n 6. "Health care provider" includes but is not limited to an entity\nlicensed or certified under article twenty-eight or thirty-six of this\nchapter; an entity licensed or certified under article sixteen,\nthirty-one or thirty-two of the mental hygiene law; or a health care\npractitioner licensed or certified under title eight of the education\nlaw or a lawful combination of such health care practitioners; and may\nalso include, to the extent provided by regulation of the commissioner,\nother entities that provide technical assistance, information systems\nand services, care coordination and other services to health care\nproviders and patients participating in an ACO.\n 7. "Medicare-only ACO" means an ACO issued a certificate of authority\nunder subdivision four of section twenty-nine hundred ninety-nine-p of\nthis article.\n 8. "Primary care" means the health care fields of family practice,\ngeneral pediatrics, primary care internal medicine, primary care\nobstetrics, or primary care gynecology, without regard to board\ncertification, provided by a health care provider acting within his,\nher, or its lawful scope of practice.\n 9. "Third-party health care payer" has its ordinary meanings and may\ninclude any entities provided for by regulation of the commissioner,\nwhich may include an entity such as a pharmacy benefits manager, fiscal\nadministrator, or administrative services provider that participates in\nthe administration of a third-party health care payer system.\n