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New York State Department of Financial Services Summarizes Changes Relating to Administrative Denials, Prior Authorizations, and Claims Payment | Epstein Becker & Green

To embed, copy and paste the code into your website or blog: On March 10, 2021, the New York State Department of Financial Services (“DFS”) issued Insurance Circular Letter No. 4 (“Circular Letter”),[1] which both explains modifications to the Insurance Law and the Public Health Law brought about by statutory changes in 2021 and sets forth two policy statements by DFS. More specifically, the Circular Letter summarizes a host of important statutory changes relating to common managed care issues, including administrative denials, utilization review, coding, and denials of pre-authorized services. In addition to covering statutory changes, the Circular Letter clarifies the DFS’s positions on when down-coding requires a utilization review determination and on the subsequent denial of a claim that had received pre-authorization. These changes relate to commercial and Medicaid products in New York; they do

FRB Compiles FAQs On Banking Regulations - Finance and Banking

To print this article, all you need is to be registered or login on Mondaq.com. The Federal Reserve Board compiled FAQs on existing legal interpretations from FRB Orders, preambles to proposed and final rulemakings, letters to institutions and other written and verbal guidance. The FRB grouped the FAQs based on the following regulations: Regulation H ( Membership of State Banking Institutions in the Federal Reserve System ), concerning the application and conditions for membership in the Federal Reserve System, dividends, establishment and maintenance of branches, investments in premises, and securities and community development investments; Regulation K ( International Banking Operations ), concerning investments and activities abroad,

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