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.
Evan Gwilliam, DC, MBA, CPC
Dr. Evan Gwilliam graduated as valedictorian from Palmer College of Chiropractic in 2003 and later earned a master's of business administration. He is the only chiropractic physician who is also an AAPC-certified ICD-10 instructor and sits on the editorial board for ICD10Monitor.com. He is also a certified professional coder, medical compliance specialist and certified professional medical auditor; and speaks on compliance and coding topics all over the country as vice president of the ChiroCode Institute. He can be reached at drg@chirocode.com.