N.Y. Insurance Law § 5605: Review of health maintenance organization arbitration experience

§ 5605. Review of health maintenance organization arbitration

experience. No health maintenance organization shall offer enrollees the

option of electing arbitration of claims pursuant to section forty-four

hundred six-a of the public health law without notifying the

superintendent of an intention to offer the arbitration option and

obtaining the superintendent's approval. The superintendent shall

approve such requests, subject to the limitations of this section and in

a manner that allows for sufficient geographical and program diversity

to permit an effective evaluation of the arbitration experience. The

superintendent of financial services shall require health maintenance

organizations to submit, on a quarterly basis, information concerning

the numbers of enrollees who elect the arbitration option, along with

such other information as the superintendent may require.

Notwithstanding the provisions of section forty-four hundred six-a of

the public health law, no health maintenance organization shall permit

new enrollees to elect the arbitration of claims after December first,

nineteen hundred ninety-one or after such organizations have been

notified by the superintendent that five hundred thousand persons have

elected to arbitrate claims, whichever event first occurs. Within one

hundred twenty days of such date or event, the superintendent shall

submit a report to the governor and the legislature describing the

experience of health maintenance organization enrollee arbitration and

including any recommendations for the future of such program.