N.Y. Comp. Codes R. & Regs. tit. 9 § 9730.2

Current through Register Vol. 46, No. 45, November 2, 2024

Section 9730.2 - Proposed actions

When the contractor proposes to deny, discontinue, suspend or reduce coverage, it shall:

(a) review, or cause to be reviewed, the proposed action to determine its correctness on the basis of the available evidence in support of such action which shall be included in the case file;

(b) if, after the review, it is decided that the proposed action would be correct, send a timely and adequate notice of the proposed action to the applicant/participant at least 10 days before the date the action is to be taken on forms approved by the State;

(c) upon request of the applicant or participant, promptly reconsider its determination and send written notice of its determination after reconsideration to the applicant/participant, together with the information concerning the applicant's/participant's right to a fair hearing as required by sections 9720.2 and 9720.3 of this Title.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 9730.2