N.Y. Comp. Codes R. & Regs. tit. 11 § 101.10

Current through Register Vol. 46, No. 53, December 31, 2024

Section 101.10 - Exemptions

A financial risk transfer agreement whereby the health care provider receives projected innetwork capitation from an individual insurer, during any consecutive 12-month period, of no more than $250,000, shall be exempt from the provisions of this Part. A financial risk transfer agreement whereby the health care provider receives projected in-network capitation from an individual insurer, during any consecutive 12-month period, of more than $250,000 but less than $1,000,000, shall only be exempt from the following provisions of this Part:

(a) the need for the superintendent's approval of the financial risk transfer agreement, including the need to demonstrate to the superintendent the financial responsibility of the health care provider, as set forth in section 101.4(c) of this Part; and

(b) the provisions of section 101.9(a)(3) of this Part as respects the requirements for the filing of the health care provider's financial statement and the CPA opinion thereon with the superintendent.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 101.10