N.Y. Insurance Law § 4915

Prohibited practices

An external appeal agent shall not, with respect to external appeal activities, permit or provide compensation or anything of value to its employees, agents, or contractors based on:

  1. (a) either a percentage of the amount by which a claim is reduced for payment or the number of claims or the cost of services for which the person has denied authorization or payment; or
  2. (b) any other method that encourages the upholding of an adverse determination.
Log InSign Up