N.Y. Public Health Law § 2999-u: Licensure

§ 2999-u. Licensure. 1. The commissioner shall license an entity

applying for licensure as a PACE organization if the applicant

demonstrates to the satisfaction of the commissioner that the applicant

will:

(a) comply with the requirements of a PACE organization under

applicable federal law and regulations;

(b) provide a facility or facilities at which primary care and other

services are furnished to enrollees;

(c) provide an interdisciplinary team approach to care management,

care delivery and care planning;

(d) comply with this article, the applicable provisions of articles

twenty-eight, thirty-six and forty-four of this chapter and regulations

thereunder, and regulations of the commissioner under this article; and

(e) enter into a PACE organization contract and agreement with the

department and CMS.

2. (a) A PACE organization shall serve an approved geographic service

area.

(b) A PACE organization and its incorporators, directors, sponsors,

stockholders, members, and operators shall have the experience,

competence, and standing in the community as to give reasonable

assurance of their ability to operate the organization to provide a

consistently high level of care for enrollees and comply with this

article. A PACE organization shall demonstrate that where any

incorporator, director, sponsor, stockholder, member, or operator of the

organization holds, or within the past seven years has held, a

controlling interest or been a controlling person in an organization or

facility licensed under this chapter, a consistently high level of care

has been rendered in each such organization or facility.

(c) A PACE organization shall meet requirements for financial solvency

under paragraph (c) of subdivision one of section forty-four hundred

three of this chapter, including a contingent reserve requirement which

may, by regulations of the commissioner, be different from that required

by that paragraph.

(d) A PACE organization shall be deemed to be a health maintenance

organization under article forty-four of this chapter for purposes of

subdivision one of section sixty-five hundred twenty-seven of the

education law.

3. (a) The commissioner shall establish in regulation a unified

licensure process for PACE organizations that includes the applicable

program requirements of this article and articles twenty-eight,

thirty-six and forty-four of this chapter.

(b) A license under this article shall require approval of the public

health and health planning council.