NY A09946

Prohibits insurers, health maintenance organizations, and health care plans from denying payment to general hospitals for medically necessary emergency inpatient services solely because the hospital failed to provide timely notification.

Allows hospitals and insurers to mutually agree to notification requirements with payment reductions capped at the lesser of $2,000 or 12 percent of the payment amount, provided reasonable extensions are given for weekend or federal holiday emergencies.

Prevents payment reductions if the hospital could not determine the patient's insurance coverage after making reasonable efforts at the time services were provided.

Allows hospitals to resubmit claims with medical records within 30 days of payment if the claim was adjusted based on coding, requiring insurers to review and respond according to standard timeframes with detailed explanations if denying the adjustment.

Requires insurers to pay interest at the corporate tax rate on coding adjustment increases not processed within 45 days of resubmission, effective July 1, 2013.