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Reporting of Physician Disciplinary Actions by Health Maintenance Organizations – N.Y. Pub. Health Law § 4405-b

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A health maintenance organization must make a report to the appropriate professional disciplinary agency within 30 days of the occurrence of any of the following: 

  • The termination of a health care provider contract pursuant to section forty-four hundred six-d of this article for reasons relating to alleged mental or physical impairment, misconduct or impairment of patient safety or welfare; 
  • The voluntary or involuntary termination of a contract or employment or other affiliation with such organization to avoid the imposition of disciplinary measures; or 
  • The termination of a health care provider contract in the case of a determination of fraud or in a case of imminent harm to patient health.
  • Obtaining knowledge of any information that reasonably appears to show that a health professional is guilty of professional misconduct


Reports must be in writing, and should include the name, address, profession and license number of the individual, and a description of the action taken by the organization including the reason for the action and the date thereof, or the nature of the action or conduct that led to the resignation, termination of contract or withdrawal, and the date to allow a reasonable person to understand which of the reasons given led to the action of the organization or the resignation or withdrawal of the individual, and, if the reason was an act or omission of the individual, the particular act or omission.

Current as of June 2015