Insurers cannot refuse to reimburse a healthcare provider who has illegally paid third parties for patient referrals, New York’s high court ruled Monday.
The 6-1 Court of Appeals, answering a certified question from the US Court of Appeals for the Second Circuit, rejected GEICO’s argument that New York State Department of Finance regulations allow the insurer to refuse to pay licensed acupuncturist Igor Mayzenberg for services he provided to patients who were injured in car accidents.
GEICO argued it didn’t have to reimburse Mayzenberg because he illegally paid third-party non-medical professionals for patient referrals.
An insurer can’t unilaterally decide a ...
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