§ 601 — Dispute resolution process established

§ 601. Dispute resolution process established. The superintendent\nshall establish a dispute resolution process by which a dispute for a\nbill for emergency services or a surprise bill may be resolved. The\nsuperintendent shall have the power to grant and revoke certifications\nof independent dispute resolution entities to conduct the dispute\nresolution process. The superintendent shall promulgate regulations\nestablishing standards for the dispute resolution process, including a\nprocess for certifying and selecting independent dispute resolution\nentities. An independent dispute resolution entity shall use licensed\nphysicians in active practice in the same or similar specialty as the\nphysician providing the service that is subject to the dispute\nresolution process of this article for disputes that involve physician\nservices. To the extent practicable, the physician shall be licensed in\nthis state. Disputes shall be submitted to an independent dispute\nresolution entity within three years of the date the health care plan\nmade the original payment on the claim that is the subject of the\ndispute.\n