Guidance on Multi Plan Agreements for Providers from New York State Regulated Insurers

New York State Department of Health
New York Early Intervention System (NYEIS) Electronic Mailing List

Guidance on Multi Plan Agreements for Providers from New York State Regulated Insurers

Dear Colleague:

The Department is aware that insurers or insurer clearinghouses (Multiplan, Omni Plan) have sent expedited agreements to EI providers in response to claims submitted for EI services.  The expedited agreements asked providers to accept claim amounts proposed by the insurer as payment in full from the insurer for the claim, which is lower than the State-established EIP rate. 

DFS has recently informed the Department that commercial insurance plans that are regulated by New York State should not be sending these agreements to providers who submit claims for EI services.  The New York State Prompt Payment Law requires that claims be processed within 45 days or the insurer could incur a violation and payment of additional interest. 

Providers should no longer be receiving expedited agreements from insurers that are regulated by New York State.  In the event that a provider does receive an expedited agreement from an insurer that is regulated by New York State in the future, the provider should not sign the agreement. Providers can determine whether or not the insurance plan for a child is regulated by New York State by accessing the child’s home page in NYEIS and by selecting the insurance coverage option, and select view for the insurance company and policy information.  If this information is not available in NYEIS, the provider should work with the child’s service coordinator to obtain this information.  The service coordinator and/or the municipality are responsible to ensure that current insurance information for each child is updated in NYEIS or in KIDS.

Please do not reply to this e-mail announcement.

Thank You.