N.Y. Comp. Codes R. & Regs. tit. 12 § 327.9

Current through Register Vol. 46, No. 51, December 18, 2024

Section 327.9 - Payment of fees and award

Additional statutory authority: Workers' Compensation Law, 13-a(3), 13-k

(a) Each of the parties to every disputed hospital bill shall pay to the chair five per centum of the amount payable under the decision of the hospital arbitration committee or the sum of $5, whichever is greater. If there is no amount payable under such decision, or if the disputed bill is determined by notice of settlement, each party to the proceeding shall pay to the chair a minimum arbitration fee of $5. If the carrier files a notice of withdrawal of its explanation for nonpayment of a bill for services rendered on or after October 1, 1994 prior to the date set for the hearing and such notice is received by the chair less than 30 days prior to such date, the carrier shall pay to the chair a minimum arbitration fee of $5. All sums collected by the chair hereunder shall be transferred to the State treasury as reimbursement on account of the expenses of administration.

(b) Payment pursuant to a decision of the hospital arbitration committee, including a decision pursuant to notice of settlement, shall be made as follows:

(1) If the amount of the bill awarded by decision (other than pursuant to notice of settlement), is more than $100, the carrier shall promptly:

(i) pay to the hospital the amount directed in the decision, less the balance of the expense fee of five per centum due from the hospital;

(ii) pay to the chair an expense fee due from the carrier of five per centum of the amount directed in the award and decision, plus the balance of the expense fee due from the hospital and to be deducted pursuant to subparagraph (i) of this paragraph; provided, however, that for arbitration decisions on disputed bills for services rendered on or after October 1, 1994, the amounts payable to the chair as expense fees shall be billed to the carrier and collected by the board.

(2) If the amount of the bill awarded by decision is $100 or less, or the amount is determined pursuant to a notice of settlement, the carrier shall promptly:

(i) pay to the hospital the amount directed in the decision or determined as set forth in the notice of settlement;

(ii) pay to the chair the minimum expense fee of five dollars due from the carrier.

Notwithstanding the foregoing, where the bill is for services rendered on or after October 1, 1994, the carrier shall pay to the hospital the amount directed in the decision or as set forth in the notice of settlement, less $5, and shall pay to the chair a total of $10, representing the minimum expense fee of $5 due from each of the carrier and the hospital. Amounts payable to the chair shall be billed to the carrier and collected by the board.

(3) If the bill is disallowed, the carrier shall pay to the chair the carrier minimum expense fee of $5; provided, however, that if a bill for services rendered on or after October 1, 1994 is disallowed, both the carrier and the hospital shall pay to the chair the minimum expense fee of $5, which shall be billed to the carrier and hospital and collected by the board.

N.Y. Comp. Codes R. & Regs. Tit. 12 § 327.9