New York puts its prompt-pay rules, interest rate, and minimum filing window in a single section of the Insurance Law. It reaches commercial insurers, HMOs, and the state’s Medicaid managed care plans.
To see what a late New York payer owes on a specific claim, use the prompt pay interest calculator.
New York prompt pay at a glance
| Statute | N.Y. Insurance Law § 3224-a |
|---|---|
| Electronic clean claim | Pay within 30 days of receipt |
| Paper clean claim | Pay within 45 days of receipt (paper or fax) |
| Late payment | The greater of the corporate tax rate set by the Tax Commissioner or 12% per year |
| Regulator for complaints | Department of Financial Services (DFS) |
The statute
Insurance Law § 3224-a covers insurers, Article 43 corporations, and HMOs certified under Public Health Law Article 44. The current revision on the New York Senate site is dated September 19, 2025.
Clean-claim payment deadlines
Where the obligation to pay is reasonably clear, the plan must pay within 30 days of receiving a claim sent through the internet or by email, and within 45 days for a claim submitted by other means, such as paper or fax (§ 3224-a(a)).
If liability is not reasonably clear, the plan must pay any undisputed portion and, within 30 calendar days of receipt, either deny the claim in writing or request the information it needs (§ 3224-a(b)). Once it determines payment is due, it has 15 days to pay.
Not verified: subsection (a) says “thirty days” and “forty-five days” without the word “calendar”, although subsection (b) does say “calendar days”.
Interest and penalties on late payment
A late payment carries interest at the greater of the rate set by the Commissioner of Taxation and Finance for corporate taxes, or 12% per year, computed from the date payment was required (§ 3224-a(c)). Interest under $2 on a claim need not be paid.
The statute also gives plans a safe harbor from civil penalties when the Superintendent’s own examination finds they paid at least 98% of claims on time.
Which payers the law covers
- Commercial fully insured plans: Covered, for contracts issued under Insurance Law Articles 32, 42, 43, and 47 (§ 3224-a).
- HMOs: Covered. Public Health Law Article 44 plans are named in the section.
- Medicaid managed care plans: Covered, based on the statute’s own text. Section 3224-a(d)(3)(i) lists Medicaid managed care under Social Services Law § 364-j as a covered plan or product, and subsection (g) addresses Medicaid provider contracts.
- Self-funded ERISA plans: Not covered. The section reaches only state-licensed contracts, and state regulation of self-funded plans is generally preempted by ERISA § 514. We found no opt-in.
Child Health Plus, the Essential Plan, and NY State of Health exchange coverage are also listed as covered plan types in § 3224-a(d)(3).
How to file a prompt-pay complaint
Providers file prompt-pay complaints through the DFS Portal, as described on the DFS complaint page. First-time filers create a Portal account, then use “Ask for Apps” to request the Healthcare Provider Complaint application.
The Department of Health managed care complaints page sends providers with late-payment and prompt-pay issues to DFS, including for Medicaid managed care plans.
How prompt pay interacts with timely filing
New York sets a filing floor of 120 days after the date of service unless the parties agree to terms more favorable to the provider, and Medicaid managed care and Child Health Plus contracts may shorten it to no less than 90 days (§ 3224-a(g)). Under § 3224-a(h), a participating provider that misses the window because of an unusual occurrence, and has a history of timely filing, can still be paid, though the plan may reduce payment by up to 25% and may deny claims filed 365 days or more after service. The prompt-pay clock itself starts only at receipt, and our 2026 timely filing guide shows how 120 days compares with other payers.
What we could not verify
- Day type for the 30 and 45 day periods in subsection (a).
- Medicaid managed care coverage, which rests on the statute’s text. We found no DFS or DOH guidance or court decision confirming it.
- The self-funded ERISA exclusion, which is an inference from the scope language. No DFS page stating it was found.
- Treatment of the state employee plan (NYSHIP / Empire Plan).
- Which 2025 chapter law produced the September 2025 revision, and what it changed.
Sources
Billing for a practice with more than one location? See how we report denials and A/R by location.
A-Z was built inside a four-location practice. The free tools on this site are the ones we use ourselves.