N.Y. Comp. Codes R. & Regs. Tit. 10 § 83-2.5 - Review process
The department shall review applications pursuant to this Subpart, in consultation with the Attorney General and, as appropriate, the mental hygiene agencies. The factors to be considered in evaluating applications shall include, but shall not be limited to:
(a) the financial condition of the parties to
the cooperative agreement, including whether any health care provider party is
experiencing financial distress and may be forced to cease operations or
eliminate a service in the absence of the cooperative agreement;
(b) the dynamics of the relevant primary
service area, including the availability of suitable and accessible health care
services and the level of competition in the primary service area, the
likelihood that other health care providers will enter or exit the primary
service area, the health care workforce and the existence of unique challenges
such as difficulties in recruiting and retaining health care
professionals;
(c) the potential
benefits of a cooperative agreement or planning process, including but not
limited to the likelihood that one or more of the following may result from
such cooperative agreement or planning process:
(1) preservation of needed health care
services in the relevant primary service area that would be at risk of
elimination in the absence of a cooperative agreement;
(2) improvement in the nature or distribution
of health care services in the primary service area, including expansion of
needed health care services or elimination of unnecessary health care
services;
(3) enhancement of the
quality of health care provided by the parties to the cooperative
agreement;
(4) expansion of access
to care by medically-underserved populations;
(5) lower costs and improved efficiency of
delivering health care services, including reductions in administrative and
capital costs and improvements in the utilization of health care provider
resources and equipment; or
(6)
implementation of payment methodologies that control excess utilization and
costs, while improving outcomes;
(d) the potential disadvantages of a
cooperative agreement or planning process, including but not limited to the
likelihood that one or more of the following may result from such cooperative
agreement or planning process:
(1) increased
costs or prices of health care in the primary service area resulting from the
cooperative agreement, after taking into consideration improvements in quality
and outcomes;
(2) diminished
quality, availability, and efficiency of health care services;
(3) inability of health care payers or health
care providers to negotiate reasonable payment and service arrangements;
or
(4) reduced competition among
physicians, allied health professionals, other health care providers, or other
persons furnishing goods or services to, or in competition with, health care
providers and the potential for adverse health system quality, accessibility
and cost consequences;
(e) the availability of arrangements that are
less restrictive to competition and achieve the same benefits or a more
favorable balance of benefits over disadvantages attributable to any reduction
in competition;
(f) other benefits
or disadvantages identified in the course of review; and
(g) the extent to which active supervision is
likely to mitigate the disadvantages.
Notes
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