Wednesday, September 19, 2012

More Sausage, the New York Register, and Regulation 68-E

For those of you who like to watch, I bring you some more information regarding how administrative law is made in New York State.

In New York, administrative agencies that wish to promulgate new rules and regulations do so on either in an emergency basis without public review and comment, or a regular basis with an opportunity for public review and comment.  The New York State Administrative Procedure Act or "SAPA" governs how proposed rules and regulations of administrative agencies in New York become law.

The maternity ward, if you will, of administrative rules and regulations in New York is the New York Register, where preemie and full-term newborn rules and regulations are displayed for adoring parents and relatives.  And, much like real world maternity wards, one needs to visit the New York Register regularly to see the newborns.

Take, for example, the rules and regulations promulgated by the combined agency formerly known as the New York State Insurance Department -- the New York Department of Financial Services.  Since the beginning of this year, it has proposed seven insurance regulation changes on a regular basis by publishing them in the New York Register.  A Notice of Proposed Rule Making that accompanies the proposed rule or regulation will indicate, among other things, whether a public hearing is to be scheduled and how long the public comment period is to last from the proposed rule or regulation's publication in the New York Register.  Similarly, since the beginning of this year it has also published seven insurance regulation changes adopted and promulgated on an emergency basis, including the adoption of Regulation 68-E, entitled "Unauthorized Providers of Health Services", which took effect on the date it was filed with the New York Secretary of State, which the DFS's website lists as August 31, 2012.

When a proposed rule or regulation is promulgated on an emergency basis there will be an accompanying Statement of Reasons for Emergency Measure filed with the New York Secretary of State and published in the New York Register.  In Regulation 68-E's case, the accompanying Statement of Reasons for Emergency Measure dated August 31, 2012 reads:
This regulation concerns the de-authorization of certain providers of health services.  Insurance Law § 5109(a) requires the Superintendent, in consultation with the Commissioner of Health and the Commissioner of Education, to promulgate standards and procedures for investigating and suspending or removing the authorization for providers of health services to demand or request payment for health services under Article 51 of the Insurance Law upon findings of certain unlawful conduct reached after investigation, notice, and a hearing pursuant to Insurance Law § 5109.

For years, certain owners and operators of professional service corporations and other types of corporations have abused the no-fault insurance system. These persons are involved in activities that include intentionally staging accidents and billing no-fault insurers for health services that were unnecessary or never in fact rendered. Indeed, recent federal indictments have demonstrated that organized crime has infiltrated and permeated the no-fault provider network.  Such wide-scale criminal activity is estimated to have defrauded insurers of at least hundreds of millions of dollars, if not more. Insurers ultimately pass on these costs to New York consumers in the form of higher automobile premiums, and schemes such as the fraudulent staging of auto accidents endangers the innocent public. Furthermore, it places in peril the quality of care received by innocent auto accident victims and the public’s health, safety, and welfare.

It is of the utmost importance that the Superintendent, Commissioner of Health, and Commissioner of Education be able, as soon as possible, to prohibit health service providers who engage in such activities from demanding or requesting payment from no-fault insurers.

For the reasons stated above, emergency action is necessary for the public health, public safety, and general welfare.
So how does a New York insurance professional keep up on the new rules and regulations of the New York Department of Financial Services?  Several ways.  First, you can set up and use a webpage monitoring service to watch for changes to the DFS's proposed, emergency, and final insurance regulations pages.  I use the free service offered by  Or, if you prefer, you can navigate to the New York Register's webpage by clicking the image below and click the "Subscribe" button, which will create an email to to subscribe to dos.dl.listserv.DAR.ERegister, after which you can then scan and read the weekly New York Register's weekly publications.

Or you can subscribe to this blog by using the widget on the right side of this page, and I'll do my best to let you know when fresh New York insurance-flavored sausage is made.

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