§ 210. Annual consumer guide of health insurers, and entities\ncertified pursuant to article forty-four of the public health law.\n (a) The superintendent shall annually publish on or before September\nfirst, nineteen hundred ninety-nine, and annually thereafter, a consumer\nguide to insurers providing managed care products, individual accident\nand health insurance or group or blanket accident and health insurance\nand entities licensed pursuant to article forty-four of the public\nhealth law providing comprehensive health service plans which includes,\nin detail, a ranking from best to worst based upon each company's claim\nprocessing or medical payments record during the preceding calendar year\nusing criteria available to the department, adjusted for volume of\ncoverage provided. Such ranking shall also take into consideration the\ncorresponding total number or percentage of claims denied which were\nreversed or compromised after intervention by the department and the\ndepartment of health, consumer complaints to the department and the\ndepartment of health, violations of section three thousand two hundred\ntwenty-four-a of this chapter and other pertinent data which would\npermit the department to objectively determine a company's performance.\nThe department in publishing such consumer guide shall publish one\nstate-wide guide or no more than five regional guides so as to\nfacilitate comparisons among individual insurers and entities within a\nservice market area. Such rankings shall be printed in a format which\nranks all health insurers and all entities certified pursuant to article\nforty-four of the public health law in one combined list.\n (b) The superintendent shall include in such guide annually, and\ninsurers and entities certified pursuant to article forty-four of the\npublic health law shall provide to the superintendent the information\nrequired for such guide in a timely fashion, the following information:\n (1) The number of grievances filed pursuant to section forty-four\nhundred eight-a of the public health law, section three thousand two\nhundred seventeen-d of this chapter, section four thousand three hundred\nsix-c of this chapter, or article forty-eight of this chapter and the\nnumber of such grievances in which an adverse determination of the\ninsurer or entity was reversed in whole or in part versus the number of\nsuch determinations which were upheld;\n (2) Beginning September first, two thousand twenty-seven, the number\nof approvals and the number of adverse determinations in whole or part\nissued by utilization review agents pursuant to section forty-nine\nhundred three of the public health law or section four thousand nine\nhundred three of this chapter; and\n (3) The number of appeals to utilization review determinations that\nwere filed pursuant to section forty-nine hundred four of the public\nhealth law and section four thousand nine hundred four of this chapter\nand the number of such determinations that were reversed in whole or in\npart versus the number of such determinations that were upheld.\n (c) Beginning September first, nineteen hundred ninety-nine and\nannually thereafter, in addition to the information required in\nsubsections (a) and (b) of this section, the superintendent, in\nconjunction with the commissioner of health, in consultation with the\nNational Committee on Quality Assurance or a similar national\norganization, shall include in such guide the following additional\ninformation, for the most recent year in which such information is\navailable and where applicable, for health insurers, health insurers\nproviding managed care products and entities certified under article\nforty-four of the public health law providing comprehensive health\nservice plans pursuant to such article:\n (1) the percentage of physicians who are either board certified or\nboard eligible;\n (2) the percentage of primary care physicians who remained\nparticipating providers, provided howev
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