NY Ins L §3221(k)(4)(A)
August 8, 2021 2:08 pm(4)(A) Every group policy delivered or issued for delivery in this state that provides coverage for inpatient hospital care shall include... View more
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NY Ins L §3221(k)(5)(A)(i)
August 8, 2021 9:03 am(i) Every group or blanket policy delivered or issued for delivery in this state which provides hospital, surgical or medical coverage... View more
NY Ins L §3224-a(a)
August 8, 2021 1:57 am(a) Except in a case where the obligation of an insurer or an organization or corporation licensed or certified pursuant to... View more
NY Ins L §3224-a(c)(1)
August 8, 2021 1:58 am(c)(1) Except as provided in paragraph two of this subsection, each claim or bill for health care services processed in violation... View more
NY Ins L §3224-b(b)(1-3)
August 8, 2021 3:15 am(b) Overpayment to healthcare providers. (1) Other than recovery for duplicate payments, a health plan shall provide thirty days written notice... View more
NY Ins L §3238(a)
August 8, 2021 2:58 am(a) An insurer, corporation organized pursuant to article forty-three of this chapter, municipal cooperative health benefits plan certified pursuant to... View more
NY Ins L §4303(a)(2)(D)
August 8, 2021 2:07 pm(D) For the purpose of this provision, “emergency services” means, with respect to an emergency condition: (i) a medical screening examination... View more
NY Ins L §4903(a)(2-3)
August 8, 2021 3:10 pm(a) Utilization review shall be conducted by: (2) A health care professional who is appropriately trained in the principles, procedures and standards... View more
NY Ins L §4903(b)(1)
August 8, 2021 9:45 am(b)(1) A utilization review agent shall make a utilization review determination involving health care services which require pre-authorization and provide... View more
NY Ins L §4903(c)(1)
August 8, 2021 2:19 am(c)(1) A utilization review agent shall make a determination involving continued or extended health care services, additional services for an insured... View more