33-20E-12. Regulation; contracting with resolution organizations.

The Commissioner shall promulgate rules implementing an arbitration process requiring the Commissioner to select one or more resolution organizations to arbitrate certain claim disputes between insurers and out-of-network providers or facilities. The Commissioner may promulgate such other rules as reasonably necessary to facilitate the arbitration process. Prior to proceeding with such arbitration, the Commissioner shall allow the parties 60 days from the date the Commissioner received the request for arbitration to negotiate a settlement. The parties shall timely notify the Commissioner of the result of such negotiation. If within 60 days of the date that the Commissioner received the request for arbitration, the parties have neither agreed upon a settlement nor agreed that more time is needed to negotiate a settlement, or both, or either party has failed to notify the Commissioner of such settlement or need for additional time to negotiate, the Commissioner shall within five days, refer the dispute to a resolution organization. The department shall contract with one or more resolution organizations by July 1, 2021, to review and consider claim disputes between insurers and out-of-network providers or facilities as such disputes are referred by the Commissioner.