Network Adequacy and Out-of-Network Guidance

NOTE: The documents available through this page are in PDF format unless noted otherwise.

Guidance, filing instructions, and materials for implementation of the out-of-network law, Part H of Chapter 60 of the Laws of 2014.

• Network Adequacy Questions and Answers (page)
• Network Adequacy Guidance and Submission Instructions (page)
• New Plan Request Form (Word format)
• Network Adequacy Attestation for Pharmacy Only Network

Out-of-Network Law Forms

The following forms are in Word format.

• Out-of-Network Reimbursement Examples
• Model Provider Disclosure of Balance Billing Protections
• Model Issuer Disclosure of Balance Billing Protections