6/23/10 N.Y. St. Reg. INS-25-10-00017-P
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:
Proposed Action:
This is a consensus rule making to amend Part 68 (Regulation 83) of Title 11 NYCRR.
Statutory authority:
Insurance Law, sections 201, 301, 2601, 5221 and art. 51
Subject:
Charges for Professional Health Services.
Purpose:
The proposed amendment adopts the new Workers Compensation Board Dental Fee Schedule.
Text of proposed rule:
Part A of Appendix 17-C to Part 68 is repealed and the appendix heading Part A is reserved.
Text of proposed rule and any required statements and analyses may be obtained from:
Andrew Mais, NYS Insurance Department, 25 Beaver Street, New York, NY 10004, (212) 480-2285, email:
amais@ins.state.ny.usData, views or arguments may be submitted to:
Buffy Cheung, NYS Insurance Department, 25 Beaver Street, New York, NY 10004, (212) 480-5587, email:
bcheung@ins.state.ny.usPublic comment will be received until:
45 days after publication of this notice.
Consensus Rule Making Determination
Sections 201, 301, 2601, 5221 and Article 51 of the Insurance Law establish the superintendent's authority to promulgate regulations governing charges for professional health services under no-fault.
Chapter 892 of the Laws of 1977 recognized the necessity of establishing schedules of maximum permissible charges, for professional health services payable as no-fault insurance benefits, in order to contain the costs of no-fault insurance. In order to contain costs, the superintendent is required to adopt those fee schedules that are promulgated by the Chairman of the Workers' Compensation Board.
For dental services rendered on or before March 1, 2009, reimbursement was made in accordance with the dental fee schedule previously established by the Insurance Department. No-fault insurance claims for dental services rendered prior to March 1, 2009 must continue to be reimbursed in accordance with the dental fee schedule previously established by the Insurance Department.
The Workers' Compensation Board adopted a dental fee schedule effective March 1, 2009. Pursuant to Chapter 892 of the Laws of 1977, this fee schedule is also applicable to automobile no-fault insurance claims for dental services rendered on or after March 1, 2009.
No person is likely to object to the rule. The rule repeals the fee schedule previously established by the Insurance Department for dental services, which was adopted by the Insurance Department because, at the time, there was no fee schedule for dental services established by the Workers' Compensation Board. The charges for these dental services are now covered by the fee schedule established by the Workers' Compensation Board.
Job Impact Statement
The proposed amendment, which is required by statute, should have no adverse impact on jobs or economic opportunities in New York State as the rule merely repeals the fee schedule previously established by the Insurance Department for dental services. The charges for these dental services are now covered by the fee schedule established by the Workers' Compensation Board.
