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What is NYC AC § 20-901?

Quick Answer

This section mandates that owners of clinics report to the department if over fifty percent of their medical benefit billings are no-fault motor vehicle insurance claims. The report must include specific details about the clinics and their ownership. Applies to owners of no-fault insurance medical clinics.

General informational summary. Not legal advice for your situation. Consult an attorney before acting on any specific matter.

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§ 20-901 Reports.

AC § 20-901

a. Where fifty percent or more of the billings for medical benefits filed by any clinic within the preceding twelve months were no-fault motor vehicle insurance medical claims, the owner of such clinic shall submit a report to the department pursuant to paragraph c of this subdivision. b. Where fifty percent or more of the billings for medical benefits filed by all clinics owned by the same owner within the preceding twelve months were no-fault motor vehicle insurance medical claims, the owner of such clinics shall submit a report to the department pursuant to paragraph c of this subdivision. c. Beginning December 1, 2006, any report to the department required by this section shall include: (i) the name, physical address and telephone number of each clinic under the control of such clinic's owner; (ii) the name, address and telephone number of all owners of each clinic; (iii) the name, address and telephone number of any management company hired by each clinic, if applicable; and (iv) the percentage of total medical bills filed within the preceding twelve months that were no-fault motor vehicle insurance medical claims, disaggregated by clinic, where applicable. Any owner of a no-fault insurance medical clinic shall attach to such report a sworn statement stating that: (1) within the preceding twelve months, no-fault motor vehicle insurance claims comprised fifty percent or more of the total billings of an individual clinic or all clinics owned by such owner; provided, however, that the department shall not require disclosure of the actual amount of no-fault insurance medical claims billed by any such clinic; and (2) such clinic does not use, solicit, direct, hire or employ any runners. Editor's note: For related unconsolidated provisions, see Appendix A at L.L. 2006/011.

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