N.Y. Comp. Codes R. & Regs. Tit. 10 §§ 83-1.2

Current through Register Vol. 46, No. 50, December 11, 2024

Section 83-1.2 - Definitions

(a)Shared health facility or facility shall mean any arrangement or operation for the delivery of medical or health care or services which meets all of the following requirements:

(1) Any combination of four or more practitioners licensed under:

(i) article 131 of the Education Law (physician); or

(ii) article 131-A of the Education Law (physical therapist, physiotherapist, physician's associate, specialist's assistant); or

(iii) article 132 of the Education Law (chiropractor); or

(iv) article 133 of the Education Law (dentist, dental hygienist); or

(v) article 137 of the Education Law (pharmacist); or

(vi) article 139 of the Education Law (registered professional nurse, licensed practical nurse); or

(vii) article 141 of the Education Law (podiatrist); or

(viii) article 143 of the Education Law (optometrist); or

(ix) article 144 of the Education Law (ophthalmic dispensor, optician); or

(x) article 156 of the Education Law (occupational therapist); or

(xi) article 159 of the Education Law (speech pathologist, audiologist).

(2) One or more of the practitioners receives payment under the Medical Assistance Program on a fee-for-service basis;

(3) The total aggregate remuneration from the Medical Assistance Program of one or more of the practitioners exceeds $5,000 for any one month during the preceding 12 months;

(4) The practitioners practice their professions at a common physical location;

(5) The practitioners share:

(i) common waiting rooms or areas; or

(ii) examining rooms; or

(iii) treatment rooms; or

(iv) other space; or

(v) the services of supporting staff; or

(vi) equipment.

(6) A person, whether a practitioner or not:

(i) is in charge of, controls, manages or supervises substantial aspects of the arrangement or operation for the delivery of health or medical services at the practitioners' common physical location; or

(ii) makes available to the practitioners the services of administrative, nursing, clerical, secretarial, maintenance, or other supporting staff who are not employees of the practitioners.

(b)Practitioner shall mean a person who is engaged in the practice of human medicine, dentistry or related professions and duly licensed in accordance with the provisions of title VIII of the New York State Education Law.

(c)Provider shall mean any qualified physicians, dentists, nurses, optometrists and other related professional personnel receiving reimbursement from the program.

(d)Purveyor shall mean any person who, whether or not located in a building which houses a shared health facility, engages in the business of supplying to patients, directly or indirectly, any medical supplies, equipment or services for which reimbursement under the program is received, including, but not limited to, clinical laboratory services or supplies, X-ray laboratory services or supplies; inhalation therapy services or equipment; ambulance services; sick room supplies; physical therapy services or equipment; orthopedic or surgical appliances or supplies; drugs, medication or medical supplies; eyeglasses, lenses, or other optical supplies or equipment; hearing aids or devices; and any other goods, services, supplies, equipment or procedures prescribed, ordered, recommended or suggested for medical diagnosis, care or treatment.

(e)Program shall mean the New York State program of medical assistance for needy persons (Medicaid) as provided in title II of article 5 of the New York State Social Services Law.

(f)Patient shall mean anyone eligible to receive or receiving benefits under the provisions of the New York State program of medical assistance for needy persons, as provided in title XI of article 5 of the New York State Social Services Law.

(g)Commissioner shall mean the Commissioner of Health of the State of New York.

(h)Department shall mean the New York State Department of Health.

(i)Operator shall mean the owner of the premises in which a shared health facility is located, or the lessee, if the structure in which the shared health facility is located has been leased pursuant to a lease.

(j)Manager or administrator shall mean an individual designated by the shared health facility owner or operator to assume functional responsibility for the management and coordination of the activities within the facility.

(k) For purposes of this Part, a combination of four or more practitioners shall be deemed to exist for the remainder of the shared health facility registration period if at any time during such registration period four or more practitioners occupy professional office space or practice their professions at a common physical location.

N.Y. Comp. Codes R. & Regs. Tit. 10 §§ 83-1.2

Adopted, New York State Register December 17, 2014/Volume XXXVI, Issue 50, eff. 12/17/2014