New York Codes, Rules and Regulations
Title 10 - DEPARTMENT OF HEALTH
Chapter XII - Innovative Delivery Models
Part 1003 - Accountable Care Organizations
Section 1003.12 - Termination
Universal Citation: 10 NY Comp Codes Rules and Regs ยง 1003.12
Current through Register Vol. 46, No. 12, March 20, 2024
The Commissioner may limit, suspend or terminate the certificate of authority of an ACO after written notice and an opportunity for review and/or hearing based on, but not limited to, the following:
(a) Unsatisfactory performance by the ACO, ACO participants, providers/suppliers or other individuals or entities performing functions or services related to ACO activities;
(b) Unsatisfactory performance may include but is not limited to:
(1) Imminent harm to
patients;
(2) Financial fraud and
abuse;
(3) Fiscal insolvency of the
ACO;
(4) The imposition of sanctions
or other actions taken against the ACO by the accrediting organization, state,
federal or local government agency leading to inability of the ACO to comply with
the requirements under this Part;
(5)
Violations of the physician self-referral prohibition, civil monetary penalties
(CMP) law, federal or state anti-kickback statute, antitrust laws, or any other
applicable federal or state laws, rules, or regulations that are relevant to ACO
operations; and
(6) Failure to adhere
to established quality measures or comply with corrective action plans related to
poor performance on established quality of care
standards.
Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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