New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
Daniel E. Wills, DC
Dr. Daniel E. Wills, a 2004 graduate of Palmer College, practices in Columbus, Ohio, as part of a large group practice. His primary professional interests include peer and utilization review and the Ohio Bureau of Workers Compensation. He currently focuses on overturning improper file reviews. He can be contacted at drwillsdc@msn.com.