N.Y. Comp. Codes R. & Regs. tit. 11 § 152.6

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

Section 152.6 - Standards for qualified risk management program

In order to qualify for the credit, a risk management program must meet the following minimum standards:

(a) The program must be administered by the insurer or, after the insurer has investigated the entity's qualifications, by an entity designated by the insurer to administer the program on its behalf.

(b) The program must contain at least two components:

(1) a basic risk management course; and

(2) a follow-up course to be taken once every two years after first receiving the risk management premium credit.

(c) The basic risk management course must:

(1) consist of either:

(i) a lecture (or other classroom setting) format, of at least five hours in length exclusive of any breaks, covering topics related to risk management, including but not limited to recordkeeping, informed consent, legislation, legal environment, communication with patients, and office procedures; or

(ii) an internet-based course format, requiring interaction by the insured, that is equivalent to the time and content of the lecture format described in subparagraph (i) of this paragraph; and

(2) require the insured, subsequent to the lecture or internet-based course, to complete a project (such as the critical review of case studies), that is designed to demonstrate and reinforce the concepts taught in the program, which must be returned to the insurer (or the entity conducting the risk management program) within 60 days after completion of the basic course lecture or internet-based course.

(d) Satisfactory completion of both the lecture or the internet-based course and the project is required in order to grant a premium credit.

(e) In order to remain eligible for the risk management premium credit, the insured must complete the follow-up course component, which must:

(1)

(i) consist of a lecture (or other classroom setting) format of at least three hours in length exclusive of breaks; or

(ii) consist of an internet-based course format, requiring interaction by the insured, which is equivalent to the time and content of the lecture format described in subparagraph (i) of this paragraph;

(2) be designed to reinforce the concepts covered in the basic risk management course and to bring to the insured's attention any relevant developments since completion of the basic course;

(3) unless provided in the basic risk management course, contain material specific to the insured's medical specialty; and

(4) require the insured, subsequent to the lecture format or the internet-based course, to complete a project (such as the critical review of case studies), that is designed to demonstrate and reinforce the concepts taught in the program, which must be returned to the insurer (or the entity conducting the risk management program) within 60 days after completion of each follow-up course.

(f) If the program is presented in a lecture format, it must contain a methodology for verifying that the insured is present for the entire lecture period for both the basic and follow-up courses, and that the required project is completed by the insured in a satisfactory manner. If the program is presented in an internet-based course format, it must contain a methodology for verifying that the insured has logged on, taken and completed both the basic and follow-up courses, and completed the required project in a satisfactory manner. In addition, the insurer or the entity conducting the internet-based course must require the insured to affirm that he or she was the person who actually took the course and that he or she is aware that any premium credit granted by the insurer is based on his or her affirmation.

(g) If the program is presented in the lecture format, it must be taught by persons with appropriate expertise in the subject areas being covered. If the program is presented in an internet- based format, the program must be developed by persons or entities with appropriate technological expertise, and the course content must be developed by persons or entities with appropriate expertise in the subject areas covered.

(h) The program must contain a provision whereby insureds who transfer their coverage from another insurer with an approved risk management program will continue to receive the credit, if and only if such insureds have completed all requirements for the credit.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 152.6