Loading chat...
NY A03088
Bill
Status
Engrossed
6/19/2014
Primary Sponsor
Charles Lavine
Click for details
AI Summary
- Health plans must provide written notice to health care providers before using extrapolation to determine overpayments
- Health plans must apply a valid statistical methodology using stratified random sampling methods to ensure fair evaluation of audited claims
- Health plans must disclose to providers the specific type of methodology used in the extrapolation process
- Health care providers receive sixty business days to appeal audit findings resulting from extrapolation
- Providers may request review of appealed findings by a mutually agreed-upon independent third-party auditor, with costs shared equally between the health plan and provider
Legislative Description
Relates to the determination of overpayment recovery amounts for health care providers; provides certain requirements be met when the process known as extrapolation will be used.
Last Action
REFERRED TO RULES
6/19/2014
Committee Referrals
Rules6/19/2014
Rules6/18/2014
Insurance1/23/2013
Full Bill Text
No bill text available