New York Financial Services Law Article 6 - EMERGENCY MEDICAL SERVICES AND SURPRISE BILLS
601 - Dispute Resolution Process Established.
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....
602 - Applicability.
(a) This article shall not apply to health care services, including emergency services, where physician fees are subject to schedules or other monetary limitations under...
603 - Definitions.
For the purposes of this article: (a) "Emergency condition" means a medical or behavioral condition that manifests itself by acute symptoms of sufficient severity, including...
604 - Criteria for Determining a Reasonable Fee.
In determining the appropriate amount to pay for a health care service, an independent dispute resolution entity shall consider all relevant factors, including: (a) whether...
605 - Dispute Resolution for Emergency Services.
(a) Emergency services for an insured. (1) When a health care plan receives a bill for emergency services from a non-participating physician, the health care...
607 - Dispute Resolution for Surprise Bills.
(a) Surprise bill received by an insured who assigns benefits. (1) If an insured assigns benefits to a non-participating physician, the health care plan shall...
608 - Payment for Independent Dispute Resolution Entity.
(a) For disputes involving an insured, when the independent dispute resolution entity determines the health care plan's payment is reasonable, payment for the dispute resolution...