Legislation
SECTION 335
Implementation of hospital reimbursement methodology
Insurance (ISC) CHAPTER 28, ARTICLE 3
§ 335. Implementation of hospital reimbursement methodology. The
superintendent shall have the power to prescribe rules and regulations
governing insurer procedures and subscriber contract provisions
necessary to implement a hospital reimbursement methodology established
in accordance with the provisions of article twenty-eight of the public
health law, and insurer procedures and subscriber contract provisions
necessary to implement a hospital inpatient discharge review program
established in accordance with the provisions of section twenty-eight
hundred three-i of the public health law, and to establish standards,
criteria and procedures for evaluation of insurer performance in
offering contracts for hospital and medical benefits on an open
enrollment basis necessary for a determination of the hospital payment
rate conversion factor in accordance with the provisions of paragraph
(i) of subdivision eleven of section twenty-eight hundred seven-c of the
public health law.
The superintendent shall periodically report his findings and
conclusions to the commissioner of health and to the chairman and
vice-chairman of the council on health care financing concerning insurer
performance in offering contracts for hospital and medical benefits on
an open enrollment basis.
superintendent shall have the power to prescribe rules and regulations
governing insurer procedures and subscriber contract provisions
necessary to implement a hospital reimbursement methodology established
in accordance with the provisions of article twenty-eight of the public
health law, and insurer procedures and subscriber contract provisions
necessary to implement a hospital inpatient discharge review program
established in accordance with the provisions of section twenty-eight
hundred three-i of the public health law, and to establish standards,
criteria and procedures for evaluation of insurer performance in
offering contracts for hospital and medical benefits on an open
enrollment basis necessary for a determination of the hospital payment
rate conversion factor in accordance with the provisions of paragraph
(i) of subdivision eleven of section twenty-eight hundred seven-c of the
public health law.
The superintendent shall periodically report his findings and
conclusions to the commissioner of health and to the chairman and
vice-chairman of the council on health care financing concerning insurer
performance in offering contracts for hospital and medical benefits on
an open enrollment basis.