§ 587 — Prohibited practices

§ 587. Prohibited practices. 1. No health services purveyor shall\nsolicit, receive, accept or agree to receive or accept any payment or\nother consideration in any form to the extent such payment or other\nconsideration is given for the referral of services or participate in\nthe division, transference, assignment, rebate, splitting of fees, with\nany clinical laboratory or its agent, employee or fiduciary, or with\nanother health services purveyor in relation to clinical laboratory\nservices. Specifically prohibited practices shall include, without\nlimiting thereto, the following:\n (a) Acceptance of payments for rental of space for more than the fair\nmarket value or where the rental amount is affected by test ordering\nvolume or value.\n (b) Acceptance of rental payments for storage space for any supplies\nprovided by any clinical laboratory or its agent, employee or fiduciary.\n (c) Acceptance of payments for filling in proper information on\nlaboratory request forms for tests.\n (d) Receipt or acceptance of employees, agents or other fiduciaries of\nany clinical laboratory to perform any duties in the facility of any\nhealth services purveyor provided, however, that nothing in this\nsubdivision shall prohibit a hospital as defined in article twenty-eight\nof this chapter or a health maintenance organization operating in\naccordance with article forty-three of the insurance law or article\nforty-four of this chapter and a clinical laboratory from contracting\nfor laboratory management services including the provision of technical\nservices and employees for the performance of functions directly related\nto clinical laboratory operations.\n (e) Receipt or acceptance of equipment, supplies or services provided\nby any clinical laboratory or its agent, employee or fiduciary for less\nthan fair market value or when the purchase price or rental payment is\nin any way related to the reference of patients or specimens to any\nclinical laboratory.\n (f) Receipt or acceptance of any monies or other consideration from\nany clinical laboratory or its agent, employee or fiduciary as a bonus,\ncommission or fee in the form of a fixed or percentage return for the\nnumber or dollar value of laboratory tests performed or to be performed\nby any clinical laboratory to which patients or specimens are referred\nor for the number of patients or specimens referred.\n (g) The purchase of prepayment coupons, tickets, booklets or any\nvariation of such prepayment instruments as advance payments by\npurveyors of health services for clinical laboratory services to be\nrendered by any clinical laboratory.\n (h) To accept payment of money or other consideration from anyone for\nany clinical laboratory tests rendered or to be rendered on any specimen\nfor transference of the money or other consideration in whole or in part\nto any clinical laboratory or to actually be kept by the health services\npurveyor.\n (i) To accept or use directly any instrument or any clinical\nlaboratory form marked "Invoice", "Receipt", "Payment Received" or any\nother variation for issuance to patients as if the patient had been\nbilled and paid the clinical laboratory.\n (j) Receipt or acceptance of any monies or other consideration from\nany clinical laboratory or its agent, employee or fiduciary for\ninfluencing any person to refrain from using or utilizing any other\nclinical laboratory.\n 2. No clinical laboratory or its agent, employee or fiduciary shall\nmake, offer, give, or agree to make, offer, or give any payment or other\nconsideration in any form to the extent such payment or other\nconsideration is given for the referral of services or participate in\nthe division, transference, assignment, rebate, splitting of fees, with\nany health services purveyor, or with another clinical laboratory.\nSpecifically prohibited practices shall include, without limiting\nthereto, the following:\n (a) To offer or agree to give or give any payments for rental of space\nfor more than the fair market value or where the rental amount is\naffected by test ordering volume or value.\n (b) To offer or agree to give or give rental payments for storage\nspace for any supplies provided to any health services purveyor.\n (c) To offer or agree to give or give any payments for filling in\nproper information on laboratory request forms for tests.\n (d) To supply employees, agents or other fiduciaries of any clinical\nlaboratory to perform any duties in the facility of any health services\npurveyor provided, however, that nothing in this subdivision shall\nprohibit a hospital as defined in article twenty-eight of this chapter\nor a health maintenance organization operating in accordance with\narticle forty-three of the insurance law or article forty-four of this\nchapter and a clinical laboratory from contracting for laboratory\nmanagement services, including the provision of technical services and\nemployees for the performance of functions directly related to clinical\nlaboratory operations.\n (e) To offer or agree to give or give any equipment, supplies or\nservices to any health services purveyor for less than fair market value\nor when the purchase price or rental payment is in any way related to\nthe reference of patients or specimens to any clinical laboratory.\n (f) To offer or agree to give or give any monies or other\nconsideration to any health services purveyor as a bonus, commission or\nfee in the form of a fixed or percentage return for the number or dollar\nvalue of laboratory tests performed or to be performed by any clinical\nlaboratory to which patients or specimens are referred or for the number\nof patients or specimens referred.\n (g) To sell any prepayment coupons, tickets, booklets or any variation\nof such prepayment instrument as advance payments by purveyors of health\nservices for clinical laboratory services.\n (h) To send a bill to or receive payment from any health services\npurveyor for clinical laboratory services rendered to any patient, where\nsuch bill is sent in code on blank paper, without name and address of\nthe clinical laboratory, without name or address of the addressee, or\nwithout name or other identifying information of the person who was the\nrecipient of the laboratory service or in any other falsified manner.\n (i) To utilize any health services purveyor or anyone else not\nauthorized by law to collect money or other consideration from anyone\nfor any clinical laboratory tests rendered or to be rendered on any\nspecimen for transference of the money or other consideration in whole\nor in part to the clinical laboratory or to be actually kept by the\nhealth services purveyor.\n (j) To supply to any health services purveyor any printed form of a\nclinical laboratory marked "Invoice", "Receipt", "Payment Received", or\nany other variation for use by any health services purveyor issuing same\nto patients as if the patient had paid the clinical laboratory.\n (k) To offer or agree to give or give any monies or other\nconsideration for influencing any person to refrain from using or\nutilizing any other clinical laboratory.\n 3. This section shall not apply to any: (a) legally established\nhospital group purchasing program approved by the commissioner, or (b)\nany arrangement between a clinical laboratory and health maintenance\norganization operating in accordance with article forty-three of the\ninsurance law or article forty-four of this chapter approved by the\ncommissioner.\n 4. Any transaction excluded from the prohibition of section five\nhundred eighty-six of this title relating to payment for services\nrendered by clinical laboratories shall be deemed to be similarly\nexcluded from the application of this section.\n 5. No clinical laboratory or its agent, employee or fiduciary shall\nmake, offer, give or agree to make, offer or give to any person,\npartnership, corporation or other entity any payment or other\nconsideration in any form as a bonus, commission or fee for securing\nreferrals of services to the clinical laboratory except for payments\nmade to a person who is an employee of the clinical laboratory.\n 6. The public health council shall adopt and amend rules and\nregulations, subject to approval by the commissioner, to effectuate the\nprovisions and purposes of this section.\n