Circular Letter No. 9 (2000)

February 29,  2000


All Public Health Law Article 44 HMOs Including Insurance Law Article 43 Corporations with a Line of Business HMO Certificate of Authority


Inclusion of IPA Financial Statements in the HMO New York Data Requirements Annual Statement

All HMOs are reminded of the need to include the required balance sheet and statement of operations for each Independent Practice Association (IPA) they contracted with in the prior calendar year with their filed New York Data Requirements Annual Statement (Report #7).

If one or more of the IPAs that an HMO contracts with is unable to provide the financial statement to the HMO in a time frame that allows the HMO to include such statement in the HMO’s annual statement (due on April 1 of each year), the HMO should submit the following as an attachment to Report #7:

1)The name, address, and contact person for the IPA(s) that the HMO contracted with in the reporting year, but for which the financial statement is not included.

2)The estimated date such IPA statement will be available.

3)The amount of payments made during the prior calendar year to each such IPA and the estimated amount of payments for the current calendar year.

4)For each such IPA show the amount of any liability which the HMO has established at year-end for any IPA payments or withholds. Explain the liability and its disposition in the following year.

When such statement becomes available the HMO should complete a Report #7 for each IPA and submit it to:

Michael Scharff,
Supervising Insurance Examiner
Health Bureau
New York State Insurance Department
25 Beaver Street
New York, NY 10004

If you have any questions on this matter please telephone Mr. Scharff at (212) 480-5060 or e-mail him at [email protected].

Charles S. Henricks
Acting Co-Chief
Health Bureau

Thomas Zyra
Acting Co-Chief
Health Bureau