Learn About New York SBL

Federal IDR representation for providers

New York Surprise Billing Law (SBL) Overview

The New York SBL became effective in 2015. Financial Services Law Article 6 and 23, NYCRR 400.

The relevant provisions of the New York law include:

  • A requirement that reimbursement for emergency and inadvertent treatment be at the greatest of 1) the median in-network rate, 2) the usual method used by the health plan to pay out-of-network providers, such as UCR, and 3) the Medicare rate.
  • A 3-year timeline from the date of payment to initiate arbitration.
  • UCR data can be submitted and often is the prevailing position in arbitration.
  • The medical provider’s billed charge for a particular CPT code must remain the demand amount for that CPT code in arbitration.
  • NYSHIP, the carrier for NY State employees, has opted out of the state process, so, any claim disputes involving NYSHIP must be brought to the Federal IDR.

 

# of NY location federal cases all time: 1,588 resolutions (228 non-prevailing) = 86% win rate
$ of NY location federal recoveries all time: $32,527,158.65
# of NY state cases (IDR & RNYS): 770 resolutions
$ of NY state cases: $11,902,127.84
Average federal NY file value: $23,917.03
Average state NY file value: $18,310.97
Average file value fed and state: $22,067.03
NY state process win rate: 100% win rate

 

Federal Avg Recovery Federal Avg Recovery State Avg Recovery Average of All
General Surgery $29,575.93 $21,291.98 $26,959.95
Hand Surgery $9,569.59 $9,888.41 $9,638.19
Intraoperative Monitoring $13,350.46 $13,320.20 $13,348.98
Neurosurgery $70,397.68 $50,116.05 $66,781.03
Orthopedic $28,111.81 $54,060.90 $34,229.89
Other $23,161.84 $7,389.12 $15,275.48
Plastic Surgery $12,246.18 $11,827.71 $12,068.65
Trauma $50,563.68 $50,563.68

Success Metrics

Higher Arbitration Yields

Higher Arbitration Yields

Stronger reimbursement outcomes using UCR-supported positions.

Year Filing Window Utilized

3-Year Filing Window Utilized

Maximized recovery by leveraging New York’s extended arbitration timeline.

State IDR Win Consistency

State IDR Win Consistency

Proven success navigating New York’s state-specific IDR framework.

UCR Driven Awards

UCR-Driven Awards

UCR data frequently prevails as the benchmark in arbitration decisions.

Reduced Provider Write Offs

Reduced Provider Write-Offs

Improved recovery on out-of-network claims under SBL protections.

NYSHIP IDR Compliance

NYSHIP IDR Compliance

Seamless escalation to Federal IDR when NYSHIP opts out of state process.

According to CMS

New York does not have an applicable All-Payer Model Agreement that would determine the out-of-network rate.

Based on the survey response, Part AA of Chapter 57 of the Laws of 2022, and CMS communications with New York Department of Financial Services and New York Department of Health staff, CMS understands that Financial Services Law Article 6 and 23 NYCRR 400 are specified state laws that will apply for purposes of determining the out-of-network rate.

These laws apply with respect to certain items and services furnished to individuals in an insured group health plan, or group or individual health insurance coverage in New York.

According to CMS
MRR State Map

They apply to services provided by nonparticipating physicians and providers at hospital facilities and ambulatory surgical centers, including when the patient received a referral and inpatient services which follow an emergency room visit, or at nonparticipating emergency facilities.

Therefore, the federal independent dispute resolution process under sections 2799A-1(c) of the PHS Act and 45 CFR 149.510 will not apply in those cases in New York.

Letter from CMS to Governor of New York, dated July 29, 2022.

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