12 CRR-NY 328.11NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 12. DEPARTMENT OF LABOR
CHAPTER V. WORKERS' COMPENSATION
SUBCHAPTER C. MEDICAL PROVIDER AUTHORIZATION
PART 328. ARBITRATION OF MEDICAL BILLS
12 CRR-NY 328.11
12 CRR-NY 328.11
328.11 Payment of fees and award.
The parties to disputed medical bill proceedings shall each pay to the chairman a sum equal to five per centum of the amount payable under such decision or $5, whichever is greater. If there is no amount payable under such decision or if the disputed bill is determined by notice of settlement (A-4), each party to the proceeding shall pay to the chairman a minimum arbitration fee of $5. The sums so collected shall be transferred to the State treasury to reimburse it on account of the expense of administration. Payment pursuant to the decision of the arbitration committee shall be made as follows:
(a) If the amount of the bill awarded under a decision other than a notice of settlement (A-4) is more than $100, the carrier shall promptly:
(1) pay to the physician the amount directed in the award and decision, less the balance of the arbitration fee due from the physician;
(2) pay to the chairman an arbitration fee due from the carrier of five per centum of the amount directed in the award and decision plus the balance of the arbitration fee due from the physician and deducted pursuant to paragraph (1) of this subdivision.
(b) If the amount of the bill awarded under a decision is $100 or less, or the amount is determined pursuant to a notice of settlement (A-4), the carrier shall:
(1) pay to the physician the amount directed in the award and decision, or determined as set forth in the notice of settlement;
(2) pay to the chairman the minimum arbitration fee due from the carrier of $5.
(c) Pay to the chairman the carrier minimum arbitration fee of $5 if the bill is disallowed.
12 CRR-NY 328.11
Current through August 31, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: JULY 31, 2023, is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Admisnistrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of the NYS Rules.