NU Online News Service, Aug. 10, 4:56 p.m. – The New York State Insurance Department has announced the final adoption of Regulation Number 164, a regulation that establishes standards for transfers of financial risk between insurers and health care providers.
The regulation affects all carriers licensed to sell health and accident insurance in New York that want to pay providers a flat, “capitated” fee for each patient served, rather than a fee for each service delivered.
The regulation forbids providers who agree to flat-fee contracts from going after the patients if they have trouble getting the payments they expect from the carriers.