New York Codes, Rules and Regulations
Title 23 - FINANCIAL SERVICES
Chapter I - Regulations of the Superintendent of Financial Services
Part 400 - Independent Dispute Resolution for Emergency Services and Surprise Bills
Section 400.0 - Preamble

Universal Citation: 23 NY Comp Codes Rules and Regs ยง 400.0
Current through Register Vol. 46, No. 12, March 20, 2024

Part H of Chapter 60 of the Laws of 2014 provided new rights and obligations, effective March 31, 2015, concerning disputes involving bills by health care providers. Health care plans, physicians, and when applicable, other health care providers and patients, have the right to request a review by an IDRE to resolve a payment dispute regarding a bill for certain emergency services or surprise bills. Chapters 375 and 377 of the Laws of 2019, effective January 1, 2020, provided additional rights and obligations for disputes involving hospital bills for emergency services and inpatient services that follow an emergency room visit. Part YY of Chapter 56 of the Laws of 2020, effective April 3, 2020, provided new hold harmless requirements and assignment of benefits rights and obligations for emergency services, including inpatient services, that follow an emergency room visit. This Part implements the requirements of Financial Services Law Article 6 by establishing a dispute resolution process and establishing the standards for such process, including criteria and the process for certifying and selecting an IDRE.

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