265.901 New Federal Legislation re Prompt Payment and Amendment of New York State Prompt Payment Law:
MSSNY will work with the American Medical Association for the introduction of federal legislation that imposes a strong federal standard for prompt payment, following the AMA’s recommendations which include:
- requiring payment within 30 days for clean paper claims and 14 days for clean electronic claims;
- imposing stiffer fines than those currently in state laws, for insurers that fail to comply with the federal prompt payment law;
- requiring that interest be assessed on the amount of payment outstanding, and that interest increase with the length of time the claim has been delinquent;
- requiring that the insurer absorb any fees and costs that the physician may incur due to the lack of prompt payment of the claim, provided that the physician can document that these fees or costs might not have been incurred if the claim had been paid within the mandated timeframe.
MSSNY also will work with the AMA for a federal law that:
- sets a statutorily defined time limit for insurers to notify physicians that additional information is needed to process a claim;
- requires the insurer to specify, in the notice, all problems with the claim and give the physician an opportunity to provide the information needed;
- requires the insurer to pay any portion of a claim that is complete and uncontested.
Also, MSSNY will work towards amending New York’s Prompt Payment Law to:
- include all applicable provisions of the federal law mentioned above;
- provide that where New York law is stronger than federal law or addresses an issue that is not part of federal law, the state law should take precedence. (HOD 2008-55; Reaffirmed HOD 2015 in lieu of res 62; Reaffirmed HOD 2025)
