2013 New York Consolidated Laws
ISC - Insurance
Article 51 - (5101 - 5109) COMPREHENSIVE MOTOR VEHICLE INSURANCE REPARATIONS
5108 - Limit on charges by providers of health services.


NY Ins L § 5108 (2012) What's This?
 
    §  5108.  Limit  on  charges  by providers of health services. (a) The
  charges for services specified in paragraph one  of  subsection  (a)  of
  section  five  thousand  one hundred two of this article and any further
  health service charges which are incurred as a result of the injury  and
  which are in excess of basic economic loss, shall not exceed the charges
  permissible under the schedules prepared and established by the chairman
  of  the  workers'  compensation  board  for industrial accidents, except
  where the insurer or arbitrator determines that  unusual  procedures  or
  unique circumstances justify the excess charge.
    (b)  The  superintendent,  after  consulting  with the chairman of the
  workers' compensation  board  and  the  commissioner  of  health,  shall
  promulgate  rules  and  regulations  implementing  and  coordinating the
  provisions of this  article  and  the  workers'  compensation  law  with
  respect  to  charges  for  the professional health services specified in
  paragraph one of subsection (a) of section five thousand one hundred two
  of this article, including the establishment of schedules for  all  such
  services  for  which schedules have not been prepared and established by
  the chairman of the workers' compensation board.
    (c) No provider of health  services  specified  in  paragraph  one  of
  subsection  (a) of section five thousand one hundred two of this article
  may demand or request any payment in addition to the charges  authorized
  pursuant to this section. Every insurer shall report to the commissioner
  of  health  any  patterns  of overcharging, excessive treatment or other
  improper actions by a health provider  within  thirty  days  after  such
  insurer has knowledge of such pattern.

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