Insurance Law § 4916 · Title 2. Right to External Appeal
Oversight and surveillance of the external appeal process
Text — Law content up to date as of October 2, 2026, as published by the New York State Senate (Open Legislation)
§ 4916. Oversight and surveillance of the external appeal process. (a) The superintendent shall have the power to:
(1) review the activities of the health care plans and external appeal agents pursuant to this title, including the extent to which such plans and agents adhere to the standards and time frames required pursuant to this title;
(2) investigate complaints by insureds regarding requests for and processing of external appeals; and
(3) conduct random audits of health care plans and external appeal agents to determine compliance with the provisions of this title.
(b) Each health care plan and external appeal agent shall annually, in such form as the superintendent shall require, report the number of external appeals requested by insureds and the outcomes of any such external appeals.
(c) The superintendent shall annually report, by plan and by agent, such information to the governor and the legislature, provided that no such information shall be included which would otherwise be deemed confidential information within the meaning of this chapter.
Source of truth
- Edition
- Law content up to date as of October 2, 2026, as published by the New York State Senate (Open Legislation)
- Official file
- https://legislation.nysenate.gov/pdf/laws/ISC4916
- Text hash
- sha256 22c9de730430cac3ddf03416f592ac5ee4425aa865d4f63b96347e3767b5f1f0
- Composed by
- gen_ny_statutes.py 2026-11-10: the Senate's Open Legislation law tree (GET /api/3/laws/<ID>?full=true) read in document order; the Senate's PDF of the whole law (GET /pdf/laws/<ID>?full=true), read with PDFium, prints the same words in the same order
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.