N.Y. Public Health Law 238-B – Provider requests for payment
§ 238-b. Provider requests for payment. Each request for payment or bill submitted by a health care provider for clinical laboratory, pharmacy services, radiation therapy services, physical therapy services or x-ray or imaging services for which the provider knows or has reason to believe that there has been a referral by a referring practitioner who is an interested investor in the health care provider shall identify the referring practitioner by name and by professional license number or any appropriate program provider number. The provisions of this section shall not apply to requests for payment or bills the content of which are regulated solely by federal law or regulation and to services excluded pursuant to paragraph (a), (b), (c), (d) or (e) of subdivision two of section two hundred thirty-eight-a of this title from the prohibitions of subdivision one of section two hundred thirty-eight-a of this title.
Terms Used In N.Y. Public Health Law 238-B
- Health care provider: shall mean a practitioner in an individual practice, group practice, partnership, professional corporation or other authorized form of association, a hospital or other health care institution issued an operating certificate pursuant to this chapter or the mental hygiene law, a certified home health agency or a licensed home care services agency, and any other purveyor of health or health related items or services including but not limited to a clinical laboratory, a physiological laboratory, a pharmacy, a purveyor of x-ray or imaging services, a purveyor of physical therapy services, a purveyor of health or health related supplies, appliances or equipment, or an ambulance service. See N.Y. Public Health Law 238
- Interested investor: shall mean , with respect to a health care provider, an investor who is a practitioner in a position to make or to influence referrals or business to the health care provider, or who is an immediate family member of such an investor. See N.Y. Public Health Law 238
- Pharmacy services: shall mean the preparing, compounding, preserving or, the dispensing of drugs, medicines and therapeutic devices on the basis of prescriptions or other legal authority. See N.Y. Public Health Law 238
- Physical therapy services: means physical therapy as defined by § 6731 of the education law. See N.Y. Public Health Law 238
- Practitioner: shall mean a licensed or registered physician, dentist, podiatrist, chiropractor, nurse, midwife, physician assistant or specialist assistant, physical therapist, or optometrist. See N.Y. Public Health Law 238
- Radiation therapy services: shall mean the use of high energy x-rays, particles, or radiation materials for the treatment of cancer and other diseases. See N.Y. Public Health Law 238
- X-ray or imaging services: shall mean diagnostic imaging techniques which shall include but not be limited to the following:
(a) Conventional x-ray or radiology. See N.Y. Public Health Law 238