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 400.9 - IDRE record retention and compliance

Current through Register Vol. 46, No. 39, September 25, 2024

(a) An IDRE shall retain case records in accordance with 11 NYCRR 243 (Insurance Regulation 152) for audit and examination for a period of six years from the date of the IDRE's determination. The IDRE shall keep and maintain all documentation relating to a case for no less than six years from the date of the IDRE's determination. The IDRE shall maintain on file each attestation required to be submitted pursuant to section 400.3(a)(4)(ii) of this Part for six years from the date of the IDRE's determination.

(b) An IDRE shall ensure the confidentiality of medical and treatment records and review materials in accordance with 11 NYCRR 420 (Insurance Regulation 169) and 11 NYCRR 421 (Insurance Regulation 173) relating to the privacy and confidentiality of health information.

(c) Every attestation required to be submitted pursuant to section 400.3(a)(4)(ii) shall be in a form prescribed by the superintendent.

(d) An IDRE shall be subject to examination by the superintendent at any time to ascertain compliance with Financial Services Law article 6 and this Part.

(e) An IDRE shall provide ready access to the superintendent to all data, records, and information collected and maintained concerning the IDRE's dispute resolution activities.

(f) An IDRE shall provide the superintendent data, information, and reports as the superintendent determines necessary to evaluate the dispute resolution process within two business days or such other period acceptable to the superintendent.

(g) An IDRE shall consent to cooperate in court proceedings relevant to its role as an IDRE.

(h) The superintendent may suspend IDRE case assignment if the IDRE fails to comply with any of the requirements of this Part and the superintendent may require all necessary corrective actions be taken by the IDRE.

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