Statutes, codes, and regulations
New York Codes, Rules and Regulations
Title 12 - DEPARTMENT OF LABORChapter V - Workers' CompensationSubchapter C - Medical Treatment and CarePart 325 - Medical And Surgical Care And Treatment
Subpart 325-6 - Reimbursement for workers' compensation claims paid by health insurers; arbitration of disputed requests for reimbursement
Section 325-6.5 - Eligibility for arbitration

N.Y. Comp. Codes R. & Regs. tit. 12 § 325-6.5

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Current through Register Vol. 46, No. 25, June 18, 2024
Section 325-6.5 - Eligibility for arbitration
(a) Except as provided in subdivision (b) of this section, all claims for reimbursement by a health insurer which have been timely served in accordance with the provisions of section 325-6.2 of this Subpart are eligible for and subject to mandatory arbitration to be conducted under this Subpart provided the carrier:
(1) fails to make full payment or serve an objection within 90 days after the date of service of the HIMP-1 form by the health insurer on the carrier; or
(2) serves an objection to reimbursement to the health insurer within 90 days after the date of service of the HIMP-1 form by the health insurer.
(b) Claims for reimbursement that has not been established, either by acceptance of the claim or by board finding of ANCR, are ineligible for arbitration.

N.Y. Comp. Codes R. & Regs. Tit. 12 § 325-6.5

Adopted New York State Register April 6, 2016/Volume XXXVIII, Issue 14, eff.6/1/2016