{"data":{"id":"us-ny/n.y.-insurance-law-4806","jurisdiction":"us-ny","citation":"N.Y. Insurance Law § 4806","heading":"Health care facility applications","body":"§ 4806. Health care facility applications. (a) An insurer that offers\na managed care product shall, upon request, make available and disclose\nto facilities written application procedures and minimum qualification\nrequirements that a facility must meet in order to be considered by the\ninsurer for participation in the in-network benefits portion of the\ninsurer's network for the managed care product. The insurer shall\nconsult with appropriately qualified facilities in developing its\nqualification requirements for participation in the in-network benefits\nportion of the insurer's network for the managed care product. An\ninsurer shall complete review of the facility's application to\nparticipate in the in-network portion of the insurer's network and,\nwithin sixty days of receiving a facility's completed application to\nparticipate in the insurer's network, shall notify the facility as to:\n(1) whether the facility is credentialed; or (2) whether additional time\nis necessary to make a determination because of a failure of a third\nparty to provide necessary documentation. In such instances where\nadditional time is necessary because of a lack of necessary\ndocumentation, an insurer shall make every effort to obtain such\ninformation as soon as possible and shall make a final determination\nwithin twenty-one days of receiving the necessary documentation.\n  (b) For the purposes of this section, \"facility\" shall mean a health\ncare provider that is licensed or certified pursuant to article five,\ntwenty-eight, thirty-six, forty, forty-four, or forty-seven of the\npublic health law or article sixteen, nineteen, thirty-one, thirty-two,\nor thirty-six of the mental hygiene law.","path":["Insurance Law","Article 48. Managed Care Health Insurance Contracts"],"source_url":"https://legislation.nysenate.gov/api/3/laws/ISC/4806","current_through":"2026-09-11","vintage":"","retrieved_at":"2026-09-14T19:32:45Z","sha256":"d5a11b906bc182f18fa4ba7140ec45fb6dc3823728e96469b519ddbdc71ea637","source_id":"us-ny","stale":false,"prev":"us-ny/n.y.-insurance-law-4805","next":"us-ny/n.y.-insurance-law-4900"},"notice":"GroundRules: Original legal text. Not legal advice."}