The New York State Department of Financial Services issued guidance to health insurers, health care providers and independent dispute resolution entities and published a draft regulation implementing statutory reforms to New York’s independent dispute resolution process. The program addresses payment disputes between out-of-network providers and insurers while protecting patients from their financial consequences. The reforms exclude Medicaid Managed Care coverage from the process and add the Empire Plan and Student Employee Health Plan, with distinct criteria for disputes involving those plans. They also extend the time available for independent dispute resolution entities to decide cases and require providers and insurers to pay the entity before it reviews a dispute. The law takes effect Aug. 26, 2026. DFS will temporarily adopt the regulatory amendments on an emergency basis from that date to address conflicts with existing rules and operational gaps while the proposed amendments proceed through the regulatory process.
New York State Department of Financial Services2026-08-13
New York State Department of Financial Services issues guidance and draft regulation implementing health care dispute resolution reforms
The New York State Department of Financial Services issued guidance and a draft regulation implementing reforms to the independent dispute resolution process for out-of-network health care payment disputes. The changes revise covered plans, extend decision timelines and require upfront payment to dispute resolution entities. The law and emergency amendments take effect Aug. 26, 2026.