335. Implementation of hospital reimbursement methodology. The superintendent shall have the power to prescribe rules and regulations governing insurer procedures and subscriber contract provisions necessary to implement a hospital reimbursement methodology established in accordance with the provisions of article twenty-eight of the public health law, and insurer procedures and subscriber contract provisions necessary to implement a hospital inpatient discharge review program established in accordance with the provisions of section twenty-eight hundred three-i of the public health law, and to establish standards, criteria and procedures for evaluation of insurer performance in offering contracts for hospital and medical benefits on an open enrollment basis necessary for a determination of the hospital payment rate conversion factor in accordance with the provisions of paragraph (i) of subdivision eleven of section twenty-eight hundred seven-c of the public health law.
The superintendent shall periodically report his findings and conclusions to the commissioner of health and to the chairman and vice-chairman of the council on health care financing concerning insurer performance in offering contracts for hospital and medical benefits on an open enrollment basis.
Last modified: February 3, 2019