State Law

The Laws Of New York-Consolidated Laws- Financial Services Law-Article 6. Emergency Medical Services and Surprise Bills

08/17/2023 New York Section 601

Dispute resolution process established

OON-Payment Issues

The superintendent shall establish a dispute resolution process by which a dispute for a bill for emergency services or a surprise bill may be resolved. The superintendent shall have the power to grant and revoke certifications of independent dispute resolution entities to conduct the dispute resolution process. The superintendent shall promulgate regulations establishing standards for the dispute resolution process, including a process for certifying and selecting independent dispute resolution entities. An independent dispute resolution entity shall use licensed
physicians in active practice in the same or similar specialty as the physician providing the service that is subject to the dispute resolution process of this article for disputes that involve physician services. To the extent practicable, the physician shall be licensed in this state. Disputes shall be submitted to an independent dispute resolution entity within three years of the date the health care plan made the original payment on the claim that is the subject of the dispute.