located in Minnesota. In 1992, the Minnesota Department of Health amended its rule to limit co-payments to 25% of the “provider’s charge”, which, in language similar to that found in defendant’s Certificate of Coverage, it defined to mean “the fees charged by the provider which do not exceed the fees that the provider would charge any other person ...” The Minnesota Department of Health and the Administrative Law Judge that approved the rule also clarified that the provider’s “charge” was not the same thing as the amount paid to the provider, and that it was reasonable and proper for an HMO to calculate percentage co-payments based on charges, while paying providers based on contracted rates. See also Garofalo v. Empire Blue Cross and Blue Shield, 67 F.Supp.2d 343, 346 (S.D.N.Y.1999) (<HOLDING>). Having considered the plain language of the
holding that expert report addressing hospitals conduct was not required when plaintiffs sole theory against hospital was vicarious liability based on ostensible agency and explaining that the conduct by the hospital on which the agency relationship depends is not measured by a medical standard of care these are principles of agency law on which no expert report is required holding that once a rate is filed with the appropriate agency except for review of the agencys orders the courts can assume no right to a different rate on that ground that in its opinion it is the only or the more reasonable rate holding that a decision to limit a new rule of criminal constitutional law to prospective application can be based on a balancing of the purpose of the new rule the reliance placed on the previous view of the law and the effect on the administration of justice of a retrospective application recognizing that under new york law a participants copayment can be based on a hospitals actual charges while defendants contribution is based on a percentage of a statistical average rate for the hospital costs of the procedure at issue holding under new york law that while multiple documents executed at the same time and concerning the same subjectmatter are required to be read together under new york law this does not mean that  any   particularized clauses  can be lifted from one document and transferred to another