S 4123 New York Senate · 2025 Regular Session

Preserves the ability of health care providers to access the independent dispute resolution process

This bill (S 4123) ensures healthcare providers can continue using independent dispute resolution (IDR) to challenge payment rates from insurers. It directly affects doctors, hospitals, and other healthcare providers who are not contracted ("non-participating") with health insurance plans. The bill amends criteria that IDR entities must use when setting fair payment rates, requiring them to consider factors like provider qualifications, usual charges for similar services, regional rates for non-participating providers, and service complexity. These changes clarify how disputes over payment rates will be resolved, maintaining access to the IDR process.
Bill status in committee 1 of 4 stages cleared
Introduction
Feb 2025
Committee Review
Floor Vote
Governor
Introduced Feb 3, 2025 Last action Jan 7, 2026