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Home » US Law » 2022 New York Laws » Consolidated Laws » ISC - Insurance » Article 51 - Comprehensive Motor Vehicle Insurance Reparations » 5108 – Limit on Charges by Providers of Health Services.
§  5108.  Limit  on  charges  by providers of health services. (a) The
charges for services specified in paragraph one  of  subsection  (a)  of
section  five  thousand  one hundred two of this article and any further
health service charges which are incurred as a result of the injury  and
which are in excess of basic economic loss, shall not exceed the charges
permissible under the schedules prepared and established by the chairman
of  the  workers'  compensation  board  for industrial accidents, except
where the insurer or arbitrator determines that  unusual  procedures  or
unique circumstances justify the excess charge.

(b) The superintendent, after consulting with the chairman of the workers' compensation board and the commissioner of health, shall promulgate rules and regulations implementing and coordinating the provisions of this article and the workers' compensation law with respect to charges for the professional health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article, including the establishment of schedules for all such services for which schedules have not been prepared and established by the chairman of the workers' compensation board.

(c) No provider of health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article may demand or request any payment in addition to the charges authorized pursuant to this section. Every insurer shall report to the commissioner of health any patterns of overcharging, excessive treatment or other improper actions by a health provider within thirty days after such insurer has knowledge of such pattern.