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Title: Section 408.4 - Supervision by the commissioner

Effective Date


408.4 Supervision by the commissioner. The implementation of a NOP and operation of a CSFRHN shall be subject to the active supervision of the commissioner pursuant to the provisions of this Part and Parts 407, 680 and subpart 752-1 of this Title, and in accordance with the following provisions.

(a) Approval and implementation of network operational plans. A central services facility rural health network shall implement a network operational plan only after receiving the approval of the commissioner to do so.

(1) Networks seeking approval to implement an operational plan shall submit the plan simultaneously to the Department and to the HSA(s) having geographical jurisdiction in the region in which the network intends to operate.

(2) The commissioner shall consider the recommendations of the HSA(s) having jurisdiction in the region in which the network intends to operate in determining whether to approve or disapprove a NOP.

(3) The commissioner shall notify the applicant, the appropriate HSA(s), and the Public Health Council in writing of a determination to approve a NOP and of his findings concerning access and proposed efficiencies supporting such determination.

(4) Where the commissioner proposes to disapprove a network operational plan, he shall provide the applicant with a detailed written statement of the basis or bases for such disapproval.

(5) In the event that a CSFRHN fails to implement an approved network operational plan in accordance with its terms, is the subject of a resolution by the Public Health Council revoking its establishment approval or fails to provide information required or requested in the course of the commissioner's active supervision of the network, the commissioner, after a hearing, may revoke, limit or annul approval to implement a NOP. The commissioner shall notify the network, the Public Health Council and the HSA(s) having geographical jurisdiction in the region in which the network operates regarding any proposed revocation, limitation or annulment of approval to implement a NOP.

(b) Supervision of network operation. The commissioner shall actively supervise and monitor the operation of central services facility rural health networks and their participating providers to assure compliance with the intent and goals of the NOP, the requirements of Article 29-A of the Public Health Law, Parts 407, 680 and subpart 752-1 of this Title and this Part. To insure the active supervision of the commissioner, CSFRHNs and affiliated providers shall:

(1) be subject to scheduled and unscheduled surveillance visits;

(2) agree in writing to submit any documentation, reports or other information requested by the commissioner, including information necessary to complete an annual evaluation;

(3) cooperate in any review and assessment of written complaints or other documentation indicating that it is not in compliance with the intent and goals of the network development program pursuant to Sections 2950 and 2957 of the Public Health Law;

(4) certify in the annual network report that a process is in place to assure that all health care providers located in the network's service area interested in participating in the network and willing to meet the network's terms and conditions have been provided the opportunity to affiliate with the network, and that consumer input is available on a regular and on-going basis with respect to the development and operation of the CSFRHN; and

(5) submit, initially with a proposed NOP, or thereafter prior to implementing or amending, all agreements between a CSFRHN and affiliated providers, or between affiliated providers resulting from or in furtherance of the objectives of the network with which they are affiliated and which provide for arrangements involving prices, methods of payment, areas of operation or restrictions thereon or any other matter which is or may be construed to be inconsistent with the requirements of state or federal laws prohibiting monopolies, unreasonable restraints of trade and related activities. All such agreements shall contain express provisions acknowledging that:

(i) such agreements or any proposed amendments thereto, shall not be effective until approved by the commissioner;

(ii) that the commissioner may provide copies to and seek the advice of the Attorney General in making any determination to approve or disapprove such agreements; and

(iii) the parties agree to cease, suspend or amend any such agreement at any time upon receipt of written notification from the commissioner or the Attorney General to do so.

(6) The commissioner shall annually review and evaluate each agreement approved pursuant to subdivision 5 of this section as to its continuing effect on access to health services, efficiencies achieved in the provision of services and whether the advantages derived from any anticompetitive activity continue to outweigh any disadvantages, and shall issue a written report of his findings.


VOLUME C (Title 10)