N.Y. Comp. Codes R. & Regs. Tit. 10 § 47-2.1 - Definitions
(a) Program means
the Obstetric and Pediatric Practitioner Incentive Demonstration Program, also
known as the Obstetric and Pediatric Malpractice Insurance Subsidy Program, as
administered by the New York State Department of Health.
(b) Obstetric practitioner means:
(1) a New York State licensed physician who
is board certified or an active candidate for board certification in
obstetrics;
(2) a New York State
licensed physician who is board certified or eligible for board certification
in family practice and who provides obstetrical services;
(3) a New York State Education Department
licensed midwife or person certified to practice midwifery by the Department of
Health; or
(4) a licensed
registered nurse certified as an obstetric nurse practitioner by the New York
State Education Department.
(c) Pediatric practitioner means:
(1) a New York State licensed physician who
is board certified or eligible for board certification in pediatrics;
or
(2) a licensed registered nurse
certified as a pediatric nurse practitioner by the New York State Education
Department.
(d)
Obstetric group practice means an obstetric practitioner with an arrangement to
practice with one or more other obstetric practitioners whether by partnership
agreement or by forming a professional corporation.
(e) Covered services means prenatal, delivery
and post-partum services provided by an obstetric practitioner or pediatric
services provided by a pediatric practitioner for children under the age of one
in a private individual or group practice, or in a comprehensive diagnostic and
treatment center:
(1) through the prenatal
care assistance program, or the medical assistance program under the Social
Services Law; or
(2) to women and
children who are not covered for obstetric or pediatric services by the
programs set forth in paragraph (1) of this subdivision, or by private health
insurance; or
(3) through a program
approved by the commissioner pursuant to section
2506(4) of the Public
Health Law, under which the services are provided as part of a program provided
by a general hospital or a city or a county health department and without
remuneration to the practitioner.
(f) Target population means pregnant women
and children up to the age of one who:
(1)
are eligible for the prenatal care assistance program or the medical assistance
program under the Social Services Law; or
(2) are not covered for obstetric or
pediatric services by the programs set forth in paragraph (1) of this
subdivision or by private health insurance; or
(3) are eligible for a program approved by
the commissioner pursuant to section
2506(4) of the Public
Health Law under which the services are provided as part of a program provided
by a general hospital or a city or a county health department and without
remuneration to the practitioner.
(g) Malpractice insurance premium means the
cost of professional liability insurance coverage for the contract
period.
(h) Contractor means an
eligible obstetric or pediatric practitioner or group practice who has
contracted with the Department of Health for a subsidy.
(i) Subsidy means the amount of remuneration
a contractor may receive through this program for his/her malpractice insurance
premium.
(j) Designated pediatric
area means a federally designated health professional shortage area or an area
designated by New York State Board of Regents as a regents physician loan
forgiveness area.
(k) New pediatric
practitioner means a pediatric practitioner who is proposing to begin practice,
or began practice, six months before or after filing an application for a
subsidy, in a designated pediatric area.
(l) Additional service obstetric practitioner
means an obstetric practitioner or obstetric group practice that agrees to
increase the number of the target population provided covered
services.
(m) Disproportionate
share obstetric practitioner means an obstetric practitioner or obstetric group
practice that has in the past provided and agrees to continue to provide
covered services to a high number of the target population.
(n) High-number means 1/3 the average number
of deliveries performed per year per obstetrician, family practitioner, or
nurse midwife, as determined by the Department of Health.
(o) Full-time pediatric practice means
providing patient care services at least 37.5 hours per week during at least 46
weeks per year in a designated pediatric area. Up to eight hours per week
providing services to residents from the designated pediatric area in a
hospital located outside the designated area may be counted towards those
hours.
(p) General pediatric
services means ambulatory health care services provided to children under the
age of one.
(q) Comprehensive
obstetrical services means prenatal, delivery and post-partum
services.
(r) Application means an
application for a contract submitted by an obstetric practitioner, obstetric
group practice, or pediatric practitioner on forms prescribed by the
department.
(s) Average obstetrical
malpractice premium (AOMP) means the amount determined by the commissioner to
reflect the average malpractice insurance premium per delivery for
obstetricians in a geographic region.
Notes
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