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.
Mario Fucinari, DC, CPCO, CPPM, CIC
Dr. Mario Fucinari is s a certified professional compliance officer, certified physician practice manager, certified insurance consultant, and Medicare Carrier Advisory Committee member. He also serves on the speaker's bureaus for Foot Levelers, NCMIC and ChiroHealthUSA. Contact Dr. Fucinari to learn about Medicare, documentation, coding, examination, or rehabilitation training classes. For further information, email him at Doc@Askmario.com or visit his website at www.Askmario.com."