New York Codes, Rules and Regulations
Title 10 - DEPARTMENT OF HEALTH
Chapter V - Medical Facilities
Subchapter C - State Hospital Code
Article 4 - Managed Care
Part 732 - Workers' Compensation Preferred Provider Organizations
Subpart 732-2 - Operations
Section 732-2.1 - Organization and administration
Current through Register Vol. 47, No. 12, March 26, 2025
(a) The PPO shall have a governing body functioning in accordance with the provisions of section 732-1.2(d) of this Part.
(b) The PPO shall employ an administrator who shall be responsible for overseeing all facets of the operation.
(c) The PPO shall employ a medical director responsible for oversight of all aspects of medical care including the quality and appropriate utilization of services and the development, updating and assurance of compliance with medical standards. Individuals providing medical direction shall have training and experience necessary for effective performance and any such individuals who practice medicine in New York State shall comply with licensing, registration and scope of practice requirements of the State Education Department. Medical direction shall also be provided consistent with the requirement that the insurer or employer shall not have a financial interest in the PPO.
