Section 335. Implementation of hospital reimbursement methodology  


Latest version.
  • 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.