New York's Department of Financial Services issued guidance and a draft regulation Thursday to implement changes to the state's process for resolving payment disputes involving surprise medical bills.
The changes are intended to improve the independent dispute resolution process used by insurers and out-of-network health care providers while shielding patients from the financial consequences of those disputes, the department said.
The state budget amendments remove Medicaid managed care coverage from the dispute process and add the Empire Plan and Student Employee Health Plan. The law also establishes separate criteria for disputes involving those plans.
Other changes give independent dispute resolution entities more time to issue decisions and require providers and insurers to pay the resolution entity before it reviews a dispute.
Gov. Kathy Hochul signed the amendments May 28 as part of the fiscal year 2027 state budget. The law takes effect Aug. 26.
The draft regulation has a 10-day preproposal comment period that began Aug. 13. A 60-day public comment period will begin after the proposed regulation is published in the State Register.
The department said it will temporarily adopt the regulatory amendments on an emergency basis Aug. 26 to address conflicts with existing regulations and allow disputes to be handled while the standard regulatory process continues.
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