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N.Y. Pub. Health Law § 4915

Prohibited practices

2014-09-22

§ 4915. Prohibited practices. An external appeal agent shall not, with\nrespect to external appeal activities, permit or provide compensation or\nanything of value to its employees, agents, or contractors based on:\n 1. either a percentage of the amount by which a claim is reduced for\npayment or the number of claims or the cost of services for which the\nperson has denied authorization or payment; or\n 2. any other method that encourages the upholding of an adverse\ndetermination.\n

Official source: NYS Open Legislation (New York State Senate). Reproduced from public-domain New York statutes; confirm against the official source for the current text. Not legal advice.