N.Y. Insurance Law § 335: Implementation of hospital reimbursement methodology

§ 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.