Current through Register Vol. 46, No. 12, March 20, 2024
Any clinical practice management plan shall be consistent
with the following requirements:
(a)
Definitions.
(1) Chief administrative officer
shall mean the president. The president shall assure that no actions are taken
under the clinical practice plan that are inconsistent with the educational
mission of the college.
(2)
Clinical practice shall mean the act of providing all forms of medical and
health care, including patient consultations, and the act of performing
clinical investigation involving patients, for which acts a fee for
professional service is customarily charged. Clinical practice may be organized
along departmental, multi-departmental, or institutional-wide lines. Clinical
practice shall be restricted to facilities of a health sciences or medical
center, school of dentistry, College of Optometry, or affiliated institution
except:
(i) for unusual circumstances or
consultation;
(ii) during periods
of vacation, in the case of calendar year employees;
(iii) during the period following the
completion of professional obligation, in the case of academic year employees;
and
(iv) during such other times
mutually agreed upon by the employee and the chief administrative officer or
designee after discussion of elements, including but not necessarily limited to
institutional objectives and the employee's commitments as a faculty member to
instruction, research, clinical service and facility utilization.
(3) Clinical practice income shall
mean the income from fees for professional services rendered in connection with
clinical practice, including salaries paid by affiliated institutions, but
excluding any income derived from clinical practice at facilities other than
those of a health sciences or medical center, school of dentistry, College of
Optometry, or affiliated institution.
(i)
during an employee's vacation, in the case of calendar year
employees;
(ii) during the period
following the completion of professional obligation, in the case of academic
year employees; and
(iii) during
such other times as may be mutually agreed upon by the employee and the chief
administrative officer or designee after discussion of elements, including but
not necessarily limited to institutional objectives and the employee's
commitments as a faculty member to instruction, research, clinical service and
facility utilization. State basic annual salary, research grants, royalties,
honoraria for lectures and income unrelated to patient care are not considered
clinical practice income. The chief administrative officer or designee may, in
his discretion, waive from inclusion in clinical practice income salaries paid
by affiliated institutions to specific employees, if in his judgment it is in
the best interest of the institution; provided, however, such salaries shall be
included in determining maximum allowable compensation.
(4) Basic annual salary, for the limited
purpose of this Part, shall mean that salary which is obtained from the direct
appropriation of State monies for the purpose of paying wages which may not
exceed the maximum State salary for an employee's academic rank.
(b) Participation in a plan for
the management of clinical practice.
(1) Any
employee who meets all of the following criteria must be a member of a plan for
the management of clinical practice:
(i)
Serves in a position of academic or qualified academic rank in a school of
medicine or dentistry in a State University health sciences or medical center,
or College of Optometry, and who is not an intern, resident or
fellow.
(ii) Performs the
professional clinical practice of medicine, dentistry, or optometry for which a
fee for professional services is customarily charged, or a salary is
customarily paid.
(2)
The governing board may make provision for voluntary memberships for persons
not required to participate but whose membership would be mutually
beneficial.
(3) The chief
administrative officer or designee, with the approval of the chancellor, may
grant exemptions from membership to employees whose primary employment is not
with the State University of New York and who have only a limited connection
with the State University.
(c) Governing board.
(1) Management of the plan. Subject to the
requirements contained in this section, the day-to-day management of any plan
shall rest in the governing board of the plan, including but not limited to
authority to review accounts, transmit reports to the chief administrative
officer and establish supplementary guidelines for expending clinical practice
income. For purposes of auditing and accounting, the governing board may, where
appropriate, develop procedures to preserve patient confidentiality. Minutes of
governing board meetings shall be circulated to each department and be
available, at any reasonable time, for inspection by members of the practice
plan. The members of the governing board shall be accountable to the university
to implement and carry out its responsibilities set forth in this
section.
(2) Composition and
election. The governing board shall consist of one person from each clinical
department in the school or college to which the plan pertains, elected once a
year by majority vote of the members of such department who are required to be
members of a plan for the management of clinical practice, plus one at-large
member from the basic science faculty elected by a majority vote of the members
of such faculty. Procedures for the election of the governing board, which
shall provide for secret ballots and equal voting rights for eligible voters,
shall be established by the college president and the chapter president of the
certified representative of employees in the Professional Services Negotiating
Unit, subject to the approval of the chancellor, no later than 15 days from the
date a plan is received by the chancellor for implementation after a
determination that the plan is consistent with the requirements of this
section. Provided, however, if an election has not been conducted 45 days
following a determination that a plan is consistent with the requirements of
this section, the chancellor shall convene a governing board.
(3) Ex-officio members. The chief
administrative officer, or designee, and the dean shall be nonvoting members of
the governing board.
(4) Subject to
the requirements contained in this section, the governing board shall have the
power to develop and promulgate operating procedures for the orderly
transaction of its functions, including but not limited to quorums, officers,
terms of office, meetings and other items consistent with the requirements of
this section.
(d)
Accounting. Each plan shall provide for a central billing and accounting system
under the control of the governing board. The accounting system shall provide a
means to record transactions respecting collection and disbursement of clinical
practice income, including but not limited to such transactions involving a
plan member, department, school of medicine or dentistry, College of Optometry,
health sciences center, or medical center. All accounts shall be available at
any reasonable time for inspection by the chancellor, or designee, the chief
administrative officer, or designee, and representatives of the State Division
of the Budget and Department of Audit and Control. Monthly reports shall be
forwarded to the office of the vice chancellor for finance and business as
determined by that office. The governing board shall provide copies of the
annual audit to plan members at least once each year. The governing board, or
in the case of a plan organized along departmental lines, the department, shall
provide each plan member an account of the amounts billed and collected as a
result of the plan member's clinical practice and a summary of those accounts
for which payment has not been received. Any professional or academic employee
who is a plan member may authorize, on his or her behalf, the duly certified
employee organization representing the Professional Services Negotiating Unit
to request such information no more frequently than twice each year. Each plan
member shall be required annually to provide such data as may be necessary for
the institution to comply with the appropriate sections of the Public Health
Law. Where clinical practice at an institution is organized along departmental
lines the chancellor shall approve a departmental billing system if the
chancellor determines it adequately complies with the above standards. In no
event shall individual plan members be permitted to bill directly for fees for
professional services.
(e)
Auditing. All accounts shall be audited annually by independent auditing firms
chosen by the governing boards to determine whether the operations of each plan
for the management of clinical practice have been conducted in accordance with
generally accepted accounting principles, the provisions of the plan for the
management of clinical practice and supplementary guidelines for disbursement
of clinical practice income developed by a governing board.
(f) Maximum allowable compensation. At least
once annually, the chief administrative officer or designee shall provide to
each employee who is required to be a member of a clinical practice plan a
statement in writing which sets forth the maximum allowable compensation which
such employee may earn from all sources, including State basic annual salary,
clinical practice income as previously defined, salary from an affiliated
hospital and research grants, but excluding royalties, honoraria and income
unrelated to patient care; provided, however, that compensation from a research
sponsor shall be subject to the regulations of the sponsor. Such maximum
allowable compensation shall be arrived at by the chief administrative officer
or designee after consultation with the employee, the employee's department
chairperson and the dean, and after considering the employee's present
commitments and future goals in teaching, patient care and research, as well as
the amount of clinical practice income attributable or likely to be
attributable to the employee. With due consideration of the factors stated
above, an employee's maximum allowable compensation shall not be unreasonably
fixed at less than 250 percent of maximum State basic annual salary for the
employee's rank when clinical practice income attributable to the employee, or
available to the employee under provisions of a plan for management of clinical
practice, permits maximum allowable compensation to be fixed at such
percentage. Except as specifically provided hereafter, the maximum allowable
compensation may not exceed 250 percent of the maximum State basic annual
salary for a member's rank. In special circumstances relating to recruitment of
employees, the chief administrative officer or designee may authorize a newly
recruited employee who is required to be a member to receive more than 250
percent of the maximum salary for such member's rank, if in the chief
administrative officer's judgment the best interest of the institution is
served, but in no event shall this authorization extend beyond the first two
years of such member's employment. With the approval of the chancellor, or
designee, the maximum allowable compensation of individual plan members may be
increased to 275 percent of the maximum State basic annual salary. In
exceptional cases related to the retention of physicians in difficult to retain
specialties, the employee's maximum allowable compensation may exceed 275
percent with the approval of the chancellor or designee. In making such
recommendations, the chief administrative officer shall give due consideration
to the competition for individuals in the particular specialty as indicated by
the Association of the American Medical Colleges' compensation data, and the
hospital and other revenue generated by the employee's clinical activities.
Such exceptions shall not exceed five percent of the total number of physicians
on a system wide basis. The State shall pay fringe benefits only on the State
basic annual salary. With the approval of the chief administrative officer or
designee, the State and the certified representative of employees in the
Professional Services Negotiating Unit, members of a clinical practice
management plan at each school may elect by majority vote an alternate
compensation method in which case plan members may be permitted to earn and
retain amounts generated which exceed 200 percent of the maximum allowable
State salary for such member's rank; provided, however, that 50 percent of such
amounts authorized to be earned above the 200 percent level shall be paid into
the fund in paragraph (g)(1) of this section. With the approval of the
chancellor, or designee, individual members of plans which have adopted the
alternate compensation method may be permitted to earn and retain amounts which
exceed 225 percent of the maximum allowable State salary for such member's
rank; provided, however, that 50 percent of such amounts authorized to be
earned above the 225 percent level shall be paid into the fund in paragraph
(g)(1) of this section. If selected, the alternate method shall be in lieu of
the method of compensation first described in this subdivision. After an
approved clinical practice plan has been fully operational for a period of 12
months, the members of the plan may, subject to the approval of the chancellor,
State and the certified representative of employees in the Professional
Services Negotiating Unit, elect by majority vote to change the method of
compensation initially selected; provided, however, the methods of compensation
are limited to the two methods provided in this subdivision.
(g) Disbursement of clinical practice income.
Provisions for disbursement of clinical practice income shall provide for the
following in order of priority:
(1) Five
percent of the gross clinical practice income from each plan for the management
of clinical practice shall be deposited into a fund at the school of medicine
or dentistry or College of Optometry whose plan members generated the income to
be administered by the chief administrative officer, or designee, for the
benefit of the school of medicine or dentistry, or College of Optometry;
provided, however, that $60,000 of such funds, which shall be collected
proportionately based on the amount of gross clinical practice income generated
by each of the plans, shall be available for university-wide health sciences
purposes.
(2) The State shall be
reimbursed for the costs of clinical practice experienced by it as a
consequence of clinical practice by plan members which are regular and
customary costs of a practitioner, not a hospital, including but not limited to
use of facilities, personnel, supplies and equipment. Reimbursement to the
State for the costs of clinical practice will be made pursuant to a formula
established by the chief administrative officer in consultation with the
governing board of the practice plan and approved by the chancellor in
consultation with the Governor's Office of Employee Relations. Such funds will
be deposited into the Debt Service/State University Income Fund for transfer to
the respective hospital operations IFR accounts. Affiliate institutions may be
reimbursed with the approval of the chancellor or designee for appropriately
documented costs of clinical practice experienced by them as a consequence of
clinical practice by plan members which are regular and customary costs of a
practitioner, not a hospital, including but not limited to use of facilities,
personnel, supplies and equipment.
(3) Payment of all other costs of clinical
practice determined in accordance with generally accepted accounting principles
and allowable to a practitioner as a deductible cost or expense under current
Federal Internal Revenue Service guidelines.
(4) Employees required to participate in a
plan for the management of clinical practice may be paid an amount from
clinical practice income which, together with compensation from all other
sources (exclusive of fringe benefits), does not exceed the maximum allowable
compensation arrived at in consultation with the chief administrative officer
or designee, dean, department chairperson and the employee, or such excess
amounts authorized by the chief administrative officer or designee pursuant to
subdivision (f) of this section; provided, however, that no disbursements from
clinical practice income for compensation of a plan member may be made where
such income was not earned by the member unless there is specific provision for
such disbursement in the plan for the management of clinical
practice.
(5) An amount (not to
exceed the rate the State University contributes for retirement to TIAA-CREF)
of the cash payment made under paragraph (4) of this subdivision to the
employee from clinical practice income may be used to purchase an annuity;
provided, however, that any portion of such cash payment on which retirement
contributions have already been made shall be excluded from the calculation to
be made herein.
(6) Remaining
clinical practice income shall remain in a school of medicine or dentistry or
College of Optometry, and shall be used for the benefit of the school of
medicine or dentistry, College of Optometry, or departments thereof, as
determined by the chief administrative officer, or designee, after consultation
with the governing board.