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Title: Section 86-3.1 - Definitions

Section 86-3.1 Definitions.

As used in this Subpart, health maintenance organization or HMO means any entity or entities providing a comprehensive prepaid health service plan(s) certified under article 44 of the Public Health Law. IX-C rate refers to individual hospital rates promulgated by IX-C hospital service plans pursuant to formulae certified by the Commissioner of Health. For the purposes of this Subpart, this shall currently mean the rate established for Blue Cross plans under Subpart 86-1, which constitute the only certified rates at this time. In the event that rates are certified by the commissioner for another IX-C plan in any area in which an HMO is situated, the IX-C rate shall mean the rate approved for the Blue Cross plan in that area.


VOLUME A-2 (Title 10)