N.Y. Public Health Law § 587: Prohibited practices

§ 587. Prohibited practices. 1. No health services purveyor shall

solicit, receive, accept or agree to receive or accept any payment or

other consideration in any form to the extent such payment or other

consideration is given for the referral of services or participate in

the division, transference, assignment, rebate, splitting of fees, with

any clinical laboratory or its agent, employee or fiduciary, or with

another health services purveyor in relation to clinical laboratory

services. Specifically prohibited practices shall include, without

limiting thereto, the following:

(a) Acceptance of payments for rental of space for more than the fair

market value or where the rental amount is affected by test ordering

volume or value.

(b) Acceptance of rental payments for storage space for any supplies

provided by any clinical laboratory or its agent, employee or fiduciary.

(c) Acceptance of payments for filling in proper information on

laboratory request forms for tests.

(d) Receipt or acceptance of employees, agents or other fiduciaries of

any clinical laboratory to perform any duties in the facility of any

health services purveyor provided, however, that nothing in this

subdivision shall prohibit a hospital as defined in article twenty-eight

of this chapter or a health maintenance organization operating in

accordance with article forty-three of the insurance law or article

forty-four of this chapter and a clinical laboratory from contracting

for laboratory management services including the provision of technical

services and employees for the performance of functions directly related

to clinical laboratory operations.

(e) Receipt or acceptance of equipment, supplies or services provided

by any clinical laboratory or its agent, employee or fiduciary for less

than fair market value or when the purchase price or rental payment is

in any way related to the reference of patients or specimens to any

clinical laboratory.

(f) Receipt or acceptance of any monies or other consideration from

any clinical laboratory or its agent, employee or fiduciary as a bonus,

commission or fee in the form of a fixed or percentage return for the

number or dollar value of laboratory tests performed or to be performed

by any clinical laboratory to which patients or specimens are referred

or for the number of patients or specimens referred.

(g) The purchase of prepayment coupons, tickets, booklets or any

variation of such prepayment instruments as advance payments by

purveyors of health services for clinical laboratory services to be

rendered by any clinical laboratory.

(h) To accept payment of money or other consideration from anyone for

any clinical laboratory tests rendered or to be rendered on any specimen

for transference of the money or other consideration in whole or in part

to any clinical laboratory or to actually be kept by the health services

purveyor.

(i) To accept or use directly any instrument or any clinical

laboratory form marked "Invoice", "Receipt", "Payment Received" or any

other variation for issuance to patients as if the patient had been

billed and paid the clinical laboratory.

(j) Receipt or acceptance of any monies or other consideration from

any clinical laboratory or its agent, employee or fiduciary for

influencing any person to refrain from using or utilizing any other

clinical laboratory.

2. No clinical laboratory or its agent, employee or fiduciary shall

make, offer, give, or agree to make, offer, or give any payment or other

consideration in any form to the extent such payment or other

consideration is given for the referral of services or participate in

the division, transference, assignment, rebate, splitting of fees, with

any health services purveyor, or with another clinical laboratory.

Specifically prohibited practices shall include, without limiting

thereto, the following:

(a) To offer or agree to give or give any payments for rental of space

for more than the fair market value or where the rental amount is

affected by test ordering volume or value.

(b) To offer or agree to give or give rental payments for storage

space for any supplies provided to any health services purveyor.

(c) To offer or agree to give or give any payments for filling in

proper information on laboratory request forms for tests.

(d) To supply employees, agents or other fiduciaries of any clinical

laboratory to perform any duties in the facility of any health services

purveyor provided, however, that nothing in this subdivision shall

prohibit a hospital as defined in article twenty-eight of this chapter

or a health maintenance organization operating in accordance with

article forty-three of the insurance law or article forty-four of this

chapter and a clinical laboratory from contracting for laboratory

management services, including the provision of technical services and

employees for the performance of functions directly related to clinical

laboratory operations.

(e) To offer or agree to give or give any equipment, supplies or

services to any health services purveyor for less than fair market value

or when the purchase price or rental payment is in any way related to

the reference of patients or specimens to any clinical laboratory.

(f) To offer or agree to give or give any monies or other

consideration to any health services purveyor as a bonus, commission or

fee in the form of a fixed or percentage return for the number or dollar

value of laboratory tests performed or to be performed by any clinical

laboratory to which patients or specimens are referred or for the number

of patients or specimens referred.

(g) To sell any prepayment coupons, tickets, booklets or any variation

of such prepayment instrument as advance payments by purveyors of health

services for clinical laboratory services.

(h) To send a bill to or receive payment from any health services

purveyor for clinical laboratory services rendered to any patient, where

such bill is sent in code on blank paper, without name and address of

the clinical laboratory, without name or address of the addressee, or

without name or other identifying information of the person who was the

recipient of the laboratory service or in any other falsified manner.

(i) To utilize any health services purveyor or anyone else not

authorized by law to collect money or other consideration from anyone

for any clinical laboratory tests rendered or to be rendered on any

specimen for transference of the money or other consideration in whole

or in part to the clinical laboratory or to be actually kept by the

health services purveyor.

(j) To supply to any health services purveyor any printed form of a

clinical laboratory marked "Invoice", "Receipt", "Payment Received", or

any other variation for use by any health services purveyor issuing same

to patients as if the patient had paid the clinical laboratory.

(k) To offer or agree to give or give any monies or other

consideration for influencing any person to refrain from using or

utilizing any other clinical laboratory.

3. This section shall not apply to any: (a) legally established

hospital group purchasing program approved by the commissioner, or (b)

any arrangement between a clinical laboratory and health maintenance

organization operating in accordance with article forty-three of the

insurance law or article forty-four of this chapter approved by the

commissioner.

4. Any transaction excluded from the prohibition of section five

hundred eighty-six of this title relating to payment for services

rendered by clinical laboratories shall be deemed to be similarly

excluded from the application of this section.

5. No clinical laboratory or its agent, employee or fiduciary shall

make, offer, give or agree to make, offer or give to any person,

partnership, corporation or other entity any payment or other

consideration in any form as a bonus, commission or fee for securing

referrals of services to the clinical laboratory except for payments

made to a person who is an employee of the clinical laboratory.

6. The public health council shall adopt and amend rules and

regulations, subject to approval by the commissioner, to effectuate the

provisions and purposes of this section.