The vibes are almost entirely positive with the UFC heading to New York City for the first time ever next month.

UFC 205 is sure to be one of the biggest paid gates in promotion history. More than that, running a show at Madison Square Garden has long been a goal for UFC president Dana White and execs. They have worked very hard — and spent a lot of money — getting MMA legalized in the state.

For fans, the fight card is the best of all time. Conor McGregor challenges Eddie Alvarez for the UFC lightweight title in the main event. Two other title fights — Tyron Woodley vs. Stephen Thompson and Joanna Jedrzejczyk vs. Karolina Kowalkiewicz — are also on the bill. And there's more where that came from. UFC 205 is deeper than UFC 200, and that's saying something.

The whole thing feels like a fall celebration of MMA in the Big Apple. The atmosphere during fight week and, of course, for the event at MSG on Nov. 12 should be festive. It's the hottest ticket in town.

Behind the scenes, though, there is uncertainty. Out of the regular gaze of fans, the much-maligned New York State Athletic Commission (NYSAC) will try to put its best foot forward after recent years filled with scandal, lawsuits, and damning investigations.

When MMA was legalized by New York in April, it was met with applause from those in the know. But those cheers have been put on hold for now.

A $1 million brain injury insurance policy requirement — per fighter — for pro boxing and MMA promoters has undercut all but the biggest shows. And questions still remain about the competence of a commission that is being sued by boxer Magomed Abdusalamov, left disabled with considerable neurological deficits after alleged NYSAC negligence following a 2013 bout.

In July, a state investigation determined that the NYSAC "failed to carry out its responsibilities prior to, during and after" Abdusalamov's bout.

The boxer was not given ambulance transport to the hospital; instead, he was reportedly told to hail a cab. His cornermen told ESPN's Outside the Lines that commission doctors told Abdusalamov to see a doctor a week after flying home to Florida to remove the sutures and get X-rays of a possible facial fracture.

Abdusalamov was only told to go to a hospital by a commission inspector after blood was found in his urine sample. At the hospital, he was diagnosed with a large blood clot on his brain. Abdusalamov suffered multiple strokes and was in a coma for weeks. The Dagestani fighter was in the hospital for 10 months.

"The commission's lack of appropriate emergency medical protocols and oversight procedures, as well as clear conflicts of interest among senior staff, reflect a systemic breakdown of its most basic operations," New York State inspector general Catherine Leahy Scott wrote in the 48-page report.

NYSAC chair Thomas Hoover resigned following the release of the investigation, which found that he gave free passes to fights to friends and family members and knowingly recommended an unqualified person for a commission job. Two months earlier, Gov. Andrew Cuomo's office removed executive director David Berlin, whose lawyer said he was ousted because he blew the whistle regarding commission wrongdoing to investigators

Hoover's predecessor Melvina Lathan, who was in place for the Abdusalamov fight, "failed to train staff on the proper response to medical issues that may arise after a fight," per the investigation, and was found to have received improper gifts from promoters. Hoover replaced her in January 2015.

Berlin wrote in a letter to Cuomo in May, which has been obtained by MMA Fighting, that he was told he was being replaced because there was "too much turmoil" in the commission.

"Boxers deserve better and the sport deserves better," Berlin wrote. "Turning a blind eye to corruption, handing out assignments in order to avoid complaints, silently accepting edicts that are wrong for the sport and for the Commission — these may be ways to avoid ‘turmoil,' but they do not move the sport forward and they do not protect the interests of boxers."

A new regime is in place now. Anthony Giardina is the acting executive director and Ndidi Massay is the interim chairperson. Eric Bentley, who became executive director after Berlin's departure, is back to his post as director of boxing and Kim Sumbler is the new MMA project coordinator.

"I'm confident boxing and MMA will thrive in the state of New York with the team we have," Ndidi Massay, the interim chairperson, told George Willis of the New York Post last month. "It's a great opportunity for athletes, for businesses and for the communities involved. We're all looking forward to seeing boxing grow and the birth of MMA in New York."

Giardina and Massay don't have much experience in combat sports, which is a concern. Sumbler worked 13 years with the upstate Seneca Gaming Corporation, which ran MMA shows, and multiple sources told MMA Fighting that she is very competent. Sumbler represented the NYSAC at the annual Association of Boxing Commissions and Combative Sports (ABC) Conference in August.

Combat sports journalist Thomas Hoover has reported that the NYSAC is still under two separate federal investigations. Department of State spokesperson Laz Benitez denied that in an e-mail to MMA Fighting. The only investigation to their knowledge, Benitez said, was the one from the inspector general.

"The Department of State appreciated the work of the State Inspector General, and we thank her for the many sensible recommendations she offered to enhance policy and procedures to be followed by the New York State Athletic Commission," Benitez said. "Fighter safety and the integrity of combative sports in New York State remain our top priorities. The Department has taken a number of recent regulatory actions to implement many of the recommendations included in this report, and will be working on additional changes."

Aside from safety, what has many promoters worried is the $1 million brain injury insurance policy requirement. It's unprecedented in this space. High-end boxing promotions and the UFCs and Bellators of the world might be able to afford it, but it seems to be keeping out mid-to-small level shows in both boxing and MMA.

In August, two well-known New York boxing promoters — Joe DeGuardia and Lou DiBella — wrote a letter expressing this concern to the New York Department of State.

"All boxing in the state of New York — marquee events and club shows alike -— are under an immediate danger of extinction," the letter read.

Alliance MMA president Rob Haydak, the former president of New Jersey's Cage Fury Fighting Championships (CFFC), told MMA Fighting that he expects the cost of running a show to be "easily four or five times" more than is typical because of the insurance issue. Haydak is still planning on running an Alliance show in New York next year, he said.

"By creating this sort of barrier of entry with this insurance regulation that they have, there's no question it's going to keep the smaller promoters out or at least make it very difficult for them to go in and run a profitable [show]," Haydak said. "At the same time, I also see some positives in that you're not going to saturate the market with a number of promotions.

"I think you will see the higher-tier promotions still do events in New York. Hopefully, as the commission and the state officials become comfortable with the sport itself, I think some of those requirements will be lessened and that will obviously benefit the smaller promotions."

On top of the restrictiveness, critics believe that the insurance policy isn't so much a protection for the athlete as it is for the commission and state. If a fighter is in need of such insurance, some have said, then the damage is already done.

"It protects them on the back end from financial responsibility," Absudalamov's lawyer Paul Edelstein told the New York Post. "It doesn't protect any boxer from anything on the front end. It's just a back-door measure to provide insurance protection from some party that might be responsible of negligence."

It also could limit fighters' options as far as where they can fight.

"The million-dollar provision, which at first blush might sound protective of fighters, in fact does them a grave disservice as they will no longer have the opportunity to fight in New York," Berlin told MMA Fighting by e-mail.

Currently, the NYSAC is still waiting for an insurance company to acutely underwrite the hefty $1 million policy. Benitez, the Department of State spokesperson, said two companies, AIG and United States Fire Insurance Co., have filed forms to sell the boxing and MMA medical insurance in New York. Benitez said the state believes those filings will be confirmed soon by the Department of Financial Services and UFC 205 will not be affected.

As far as the cost to promoters, Benitez said there is a belief the rates will be "reasonable" and the regulation is in place for the good of the fighters.

"NYSAC's primary objective is to ensure the safest environment for combative sports in the nation so that combat athletes competing in New York State incur the fewest and least severe injuries possible," Benitez said. "While some combative sports industry professionals expressed concern over the premiums for the $1 million coverage, these amounts are as yet determined. However, from discussions with insurers about to enter the market, we believe the costs will be reasonable."

Along with UFC 205 on Nov. 12, the UFC will also run a Fox Sports 1 card, UFC Fight Night: Lewis vs. Abdurakhimov, in Albany on Dec. 9. World Series of Fighting will bring a card to the MSG Theater on Dec. 31. Bellator has also been licensed to promote in the state.

The novelty of running these shows in New York just months after the ban on the sport there has been lifted will wear away soon enough. The UFC will certainly hold events at Madison Square Garden every year. Bellator is sure to be at Barclays Center before long. But the actual health of combat sports in the state beyond that is in question.

Boxing promoters who have run events in New York for decades have never had to worry about this insurance provision before. Brooklyn's Danny Jacobs, a regular at Barclays, fought last month in Reading, Pa. — not his hometown — in part because of the cost. MMA promoters will feel the burden as well. This was not what many thought when they were fighting to get the sport legalized in the state.

Even if the NYSAC has cleaned up its act, even if those reported investigations turn out to be nothing, this is going to be a growing issue in the coming months and years.

Behind the curtain of the UFC spectacle is legitimate apprehension.