N.Y. Department Levies More than $415,000 in Prompt Pay Violations

February 2, 2004

New York Superintendent of Insurance Gregory Serio announced that the Department has finalized another round of fines against health insurers and HMOs for reportedly violating the state’s Prompt Pay Law.

The 30 insurers and HMOs have been fined a total of $418,120 for failing to pay their claims on time. More notably is that prompt pay complaints are at a record low of 13,577 for 2003. This is a decrease of 31 percent from over 19,500 complaints in 1998.

“The Department’s priority is to ensure that New York health insurance consumers are paid promptly. Since the Law was enacted, the Department has seen a marked decrease in the number of prompt pay complaints, indicating that this Law is having a positive impact and health insurers are making it a priority to pay consumers and providers in a timely manner,” said Serio. “The Department remains committed to ensuring that health insurers comply with the Law and meet their obligation to pay undisputed claims timely or they will continue to be fined for failure to do so.”

The Prompt Pay Law, which went into effect in January 1998, requires all health insurers to pay undisputed health insurance claims within 45 days of receipt – ensuring the timely payment of claims. HMOs and health insurers have been fined a total of $5,397,520 since the Law went into effect.

The round of fines cover prompt pay complaints closed from January 2001 through December 2002.

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