STATE OF NEW YORK
25 BEAVER STREET
NEW YORK, NEW YORK 10004
|George E. Pataki
Gregory V. Serio
|Circular Letter No. 8 (2004)
October 5, 2004
|TO:||ALL MOTOR VEHICLE AUTOMOBILE SELF-INSURERS, AND INSURERS AUTHORIZED TO WRITE MOTOR VEHICLE INSURANCE IN NEW YORK STATE AND THE MOTOR VEHICLE ACCIDENT INDEMNIFICATION CORPORATION|
|RE:||REVISION TO THE NO-FAULT FEE SCHEDULES - ADOPTION OF THE 28th AMENDMENT TO REGULATION 83|
|STATUTORY REFERENCE: SECTION 5108 OF THE INSURANCE LAW|
|The purpose of this
Circular Letter is to inform providers of No-fault benefits that the
Department has promulgated the 28th
Amendment to Regulation No. 83, effective October 6, 2004.
The prior fee schedule for durable medical equipment and supplies contained in Regulation 83 failed to definitively establish consistent and reasonable values for the cost of durable medical equipment and supplies, resulting in numerous disputes between providers and insurers many of which proceeded to no-fault arbitration and the courts for resolution. The adoption of an established fee schedule that is updated as necessary to reflect increased costs and to include newer products as they are developed will provide for more timely payment of health care provider charges and result in a significant reduction in litigation costs that are being incurred due to the variable nature of the current fee schedule rule used to establish these costs. Utilization of the established New York State Medicaid fee schedules for durable medical equipment, medical/surgical supplies, orthopedic footwear and orthotic and prosthetic appliances should significantly reduce the number of disputes between insurers and health care providers, resulting in more uniform, efficient and cost effective processing and payment of no-fault claims.
All insurers and self-insurers must ensure that the new rules contained in the 28th Amendment to Regulation 83 will be applied properly.
If you have any questions regarding the contents of this circular letter or the 28th amendment to Regulation 83, please contact:
Debra Parris, Senior Insurance Examiner
Very truly yours,