N.Y. Workers' Compensation Law § 353: Preferred provider organizations; licensing

§ 353. Preferred provider organizations; licensing. To be licensed as

a preferred provider organization any entity, except any organization

which provides limited health care services, shall make an application

to the commissioner of health and shall submit therewith an application

fee of five hundred dollars. Such application shall be accompanied by

the information prescribed in regulation. Such information shall include

but not be limited to the following:

1. the standards by which the providers participating in the preferred

provider organization shall be selected;

2. the names and credentials of all individuals and organizations that

will provide service under the preferred provider organization, together

with appropriate evidence of compliance with all licensing or

certification requirements for such individuals or organizations to

practice in this state;

3. a description of any final disposition of professional misconduct

charges against any of the individuals or organizations which will

provide medical or other health care services under the preferred

provider organization program;

4. the names and professional qualifications of providers licensed by

the board in each medical specialty;

5. the names and certifications of hospitals from which employees may

choose in the event that hospitalization is necessary;

6. a description of the times, places and manner of providing services

under the preferred providers organization;

7. a detailed description of procedures to be followed by the

preferred providers organization for ongoing quality assurance,

utilization review and dispute resolution.

Each preferred provider organization formed pursuant to this article

shall comply with the provisions of sections forty-four hundred eight,

forty-four hundred eight-a, forty-four hundred six-c, forty-four hundred

six-d, subdivisions five and six of section forty-four hundred three and

article forty-nine of the public health law. The commissioner of

health, in consultation with the chair of the workers' compensation

board may waive or modify the application of these provisions to such

organizations where appropriate.