265.961 Accountability of Management Service Organizations:
MSSNY will seek legislation which would (a) require that management service organizations that contract with health insurance entities to review, process and pay physician-submitted claims, grant authorizations and pre-certifications where appropriate, apply internal policy payment parameters frequently without physician input, be held accountable to the same State imposed standards, i.e. the Prompt Payment Law, as all insurance entities licensed in New York State, (b) mandate that the New York State Insurance Department have jurisdiction over management service organizations which contract with health insurance entities to review, process and pay claims.
It is MSSNY policy that insurance entities licensed in New York State that contract with management service organizations should be held accountable for the actions of these contracted organizations. (HOD 2000-88; Reaffirmed HOD 2014; Reaffirmed HOD 2024)
