Section 20-900. Definitions  


Latest version.
  • For the purposes of this chapter, the following
      terms shall have the following meanings:
        1. "Clinic" shall mean any private, non-residential  medical  facility
      or  practice,  other  than  a  hospital  as defined in article 28 of the
      public health law, which provides health care services in  the  city  of
      New  York  relating  to  injuries sustained as a result of motor vehicle
      accidents.
        2. "Control", including the terms "controlling", "controlled  by"  and
      "under  common control by or with", shall mean the possession, direct or
      indirect, of  the  power  to  direct  or  cause  the  direction  of  the
      management  and policies of an institution, whether through ownership of
      voting securities, by contract or otherwise.
        3. "Health care provider" shall mean any  physician  or  other  health
      care  professional,  including,  but  not  limited to, dentists, nurses,
      x-ray  technicians,  physical  or   occupational   therapists,   massage
      therapists,  acupuncturists,  chiropractors  and  mental  health service
      professionals, licensed to practice in New York state.
        4. "Health care services" shall  mean  any  health  or  mental  health
      services  provided  by  a  health  care  provider  relating  to injuries
      sustained as a result of an actual or alleged  motor  vehicle  accident,
      including  but  not  limited  to  medical,  hospital, surgical, nursing,
      dental, ambulance, x-ray,  diagnostic,  prescription  drug,  prosthetic,
      psychiatric,   massage,   acupuncture,  chiropractic,  and  physical  or
      occupational therapy and rehabilitation services.
        5. "Insured" shall mean any person who  owns  a  policy  of  insurance
      issued  by  a no-fault motor vehicle insurer that insures against losses
      or liabilities arising out of the ownership,  operation,  or  use  of  a
      motor vehicle.
        6.  "Medical  benefits" shall mean full or partial payments for health
      care services.
        7. "Motor vehicle" shall mean  any  vehicle  operated  upon  a  public
      highway  or  public  street  propelled  by any power other than muscular
      power.
        8. "No-fault insurance medical clinic" shall mean any clinic  that  is
      subject to the requirements of this chapter.
        9.  "No-fault  motor  vehicle  insurance medical claim" shall mean any
      claim for medical benefits submitted to a no-fault motor vehicle insurer
      under a policy issued by such no-fault motor vehicle insurer pursuant to
      article 51 of the New York state insurance law,  which  provides  "first
      party  benefits"  as  that  term  is  defined in section 5102(b) of such
      article.
        10. "No-fault motor vehicle insurer" shall mean any insurer,  company,
      corporation,  partnership  or  other  individual or entity authorized to
      transact or transacting business in New York state,  or  controlling  or
      controlled  by or under common control by or with such insurer, company,
      corporation, partnership or other  individual  or  entity,  which  sells
      policies  of insurance that insure against losses or liabilities arising
      out of the ownership, operation, or use of a motor vehicle.
        11. "Owner" shall mean any owner, manager, operator or other person or
      persons having control of a clinic and any authorized agent thereof.
        12. "Runner" shall mean any  person  who,  for  a  pecuniary  benefit,
      procures  or attempts to procure a client, patient or customer when such
      person knows, or a reasonable person would know, that the purpose of  an
      owner of a no-fault motor vehicle insurance medical clinic is to falsely
      or  fraudulently:  (i)  obtain  medical  benefits  from a no-fault motor
      vehicle insurer; or (ii) assert a claim against an insured or a no-fault
      motor vehicle insurer for the provision of health care services to  such
      client, patient or customer; provided, however, that such term shall not
    
      include  a  person who procures or attempts to procure clients, patients
      or customers through public  media  or  a  person  who  refers  clients,
      patients  or  customers  as  authorized  by law. Nothing in this chapter
      shall  be  deemed  to  prohibit an agent, broker or employee of a health
      maintenance  organization  from  seeking  to  sell  health   maintenance
      organization  coverage or health insurance coverage to any individual or
      group.