Regulations for your review

August 18, 2022

Three docs attached

Good morning,

Attached, please find a Proposed Rule Making issued today by OASAS related to Requirements for the Establishment, Incorporation and Certification of Providers of Addiction Services, to update outdated and stigmatizing language and to clarify processes of the certification process for providers and applicants.

Also attached, please find a Proposed Rule Making issued today by OCFS related to Limits on Executive Compensation to remove the limits on executive compensation and administrative expenses.  

In the last attachment, please find a Revised Rule Making issued by DFS today related to Minimum Standards for the Form, Content and Sale of Health Insurance, Including Standards of Full and Fair Disclosure to apply disclosure requirements to dental and vision, and to hold issuers responsible for inaccurate network status (such as ‘in-network’ or ‘out-of-network’ status of a provider) information.  In particular this rule:

  • requires issuers to provide network status information to an insured, in writing, within one business day of the insured requesting the information by telephone
  • prohibits an issuer from imposing on an insured a cost-sharing amount, deductible, or out-of-pocket maximum that is greater than the amounts that would apply if the insured had received services from a participating provider
  • provides that if an issuer provides inaccurate network status information to an insured, the issuer must reimburse the provider for the out-of-network services regardless of whether the insured’s coverage includes out-of-network services
  • requires an issuer to include in its hard copy provider directory a notification that the information contained in the directory was accurate as of the date of publication of such directory and that an insured should consult the provider directory posted on the issuer’s website to obtain the most current provider directory information
  • holds issuers responsible when they provide inaccurate network status information
  • applies the disclosure requirements in Insurance Law Sections 3217-a and 4324 to stand-alone dental and vision insurance to ensure that insureds covered under these policies are provided accurate and up-to date information

Please let us know if you have any questions.