The court held that the amendment, which addresses insurer reimbursement for a qualified professional health service performed outside of New York State, applies prospectively only, noting that the law is settled that retroactivity is not imputed where not expressly stated. (December 20, 2018) In ...
The term "healthcare provider" is sometimes incorrectly used to refer to a health plan or health insurance company. However, an insurer or health plan administrator does not deliver care. Instead, that entity pays the person or other entity that provides the care (assuming the service is covere...
It has been reportedthat the US Insurer ‘State Farm’ is fighting a fraudulent scheme that has been exploiting New Jersey’s personal injury protection (PIP) benefits law since 2014. The insurer is seeking to recover $2.6 million in what it claims are fraudulent auto injury claims and a dec...
In fact, only by estimating the overall risk can an insurer develop a monthly premium to provide the payment for the health care benefits specified in the insurance agreement in the event that disease occurs. This is the principle upon which health care in the US and Commonwealth countries is...