Establishes timeframes for the payment of claims to hospitals and outlines procedures for reviewing medical necessity.

This bill amends the insurance law to establish timeframes for the payment of claims to hospitals. It mandates that insurers or organizations licensed under certain articles of the public health law must pay hospital claims within specified periods. Post-payment, insurers can request clinical documentation for review by a joint committee of medical directors and clinicians from both the insurer and the hospital. If the joint committee cannot reach a consensus, the matter is escalated to an independent third-party review agent.

Establishes timeframes for the payment of claims to hospitals and outlines procedures for reviewing medical necessity.

This bill amends the insurance law to establish timeframes for the payment of claims to hospitals. It mandates that insurers or organizations licensed under certain articles of the public health law must pay hospital claims within specified periods. Post-payment, insurers can request clinical documentation for review by a joint committee of medical directors and clinicians from both the insurer and the hospital. If the joint committee cannot reach a consensus, the matter is escalated to an independent third-party review agent.