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This entry was published on 2022-04-22
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SECTION 601
Dispute resolution process established
Financial Services Law (FIS) CHAPTER 18-A, ARTICLE 6
§ 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. The
superintendent shall have the power to grant and revoke certifications
of independent dispute resolution entities to conduct the dispute
resolution process. The superintendent shall promulgate regulations
establishing standards for the dispute resolution process, including a
process for certifying and selecting independent dispute resolution
entities. An independent dispute resolution entity shall use licensed
physicians in active practice in the same or similar specialty as the
physician providing the service that is subject to the dispute
resolution process of this article for disputes that involve physician
services. To the extent practicable, the physician shall be licensed in
this state. Disputes shall be submitted to an independent dispute
resolution entity within three years of the date the health care plan
made the original payment on the claim that is the subject of the
dispute.