N.Y. Public Health Law § 4414: Health care compliance programs

§ 4414. Health care compliance programs. 1. The commissioner, after

consultation with the superintendent of financial services, shall by

regulation establish standards and criteria for compliance programs to

be implemented by persons providing coverage or coverage and service

pursuant to any public or governmentally-sponsored or supported plan for

health care coverage or services. Such regulations shall include

provisions for the design and implementation of programs or processes to

prevent, detect and address instances of fraud and abuse. Such

regulations shall take into account the nature of the entity's business

and the size of its enrolled population. The commissioner and the

superintendent of financial services shall accept programs and processes

implemented pursuant to section four hundred nine of the insurance law

as satisfying the obligations of this section and the regulations

promulgated thereunder when such programs and processes incorporate the

objectives contemplated by this section.

2. Notwithstanding any provisions of section twelve of this chapter to

the contrary, penalties collected from any health maintenance

organization certified pursuant to this article resulting from a

violation of the health maintenance organization's mental health and

substance use disorder parity compliance program shall be deposited into

the behavioral health parity compliance fund as established pursuant to

section ninety-nine-hh of the state finance law.