# New York prompt-pay law for dental claims

> What is the New York prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (N.Y. Ins. Law §3224-a).

URL: https://dentovio.com/dental-prompt-pay-laws/new-york

Last verified: 2026-08-30

Dentovio is an independent publisher, not a law firm, insurance department, or government agency. This page was drafted with AI assistance and read against the primary sources linked here, with a per-claim verification record — quote, statutory pinpoint, and the URL actually opened — behind every deadline, rate, and applicability verdict in all fifty-one jurisdictions. It has not been reviewed by a credentialed attorney or dental billing specialist. These pages summarize state prompt-pay statutes as read against the official sources on the date shown, focusing on how each statute treats dental claims. Statutes change and their application turns on plan type, contract status, and claim facts. Educational reference only — not legal advice; confirm current law with the state insurance department or a licensed attorney before acting on a specific claim.

## Direct answer

Under N.Y. Ins. Law §3224-a, the New York payment deadline is 30 days (internet or electronic mail) and 45 days (paper, facsimile, or other means). Late payment carries interest "of the greater of the rate equal to the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the claim or health care payment was required to be made" (§3224-a(c)(1)). Dental applicability: Section 3224-a applies to "all health care claims submitted under contracts or agreements" and to "all bills for health care services rendered by health care providers pursuant to such contracts or agreements," and it binds an insurer or an organization or corporation licensed or certified under Insurance Law article 43 or 47 or Public Health Law article 44. A self-funded private-employer (ERISA) plan is generally beyond this statute's reach and runs on the federal claims-procedure clock instead — but that comes from the courts reading 29 U.S.C. § 1144, not from its text, and it is not categorical: a self-funded governmental or church plan is not an ERISA plan at all, § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law, and nothing in § 1144 bars a state from reaching the third-party administrator or the network contract.

## Payment deadlines

- Electronic claims: 30 days (internet or electronic mail)
- Paper claims: 45 days (paper, facsimile, or other means)

Payment is due within 30 days of receipt of a claim or bill transmitted via the internet or electronic mail, or 45 days of one submitted by other means such as paper or facsimile. The duty carries a standing exception: it does not apply where the obligation to pay is not reasonably clear, or where there is a reasonable basis supported by specific information that the claim was submitted fraudulently. On a disputed claim the payer must pay the undisputed portion and, within 30 days, either deny in writing with specific reasons or request additional information (§3224-a(b)).

## Interest and penalties on late payment

Late payment carries interest "of the greater of the rate equal to the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the claim or health care payment was required to be made" (§3224-a(c)(1)). Interest under two dollars is not payable. The 98 percent safe harbor at §3224-a(c)(2) shields an insurer from the superintendent's civil penalty in a superintendent-initiated investigation but expressly does not excuse paying the claim or the interest. New York courts have also recognised an implied private right of action for health care providers: Maimonides Med. Ctr. v. First United Am. Life Ins. Co., 116 AD3d 207 (2d Dep't 2014).

## Does it apply to dental? Dental scope unsettled

Section 3224-a applies to "all health care claims submitted under contracts or agreements" and to "all bills for health care services rendered by health care providers pursuant to such contracts or agreements," and it binds an insurer or an organization or corporation licensed or certified under Insurance Law article 43 or 47 or Public Health Law article 44. The text names no dental inclusion and no dental exclusion, and the sources read here did not resolve whether a stand-alone dental carrier sits inside — so the question stays open rather than being answered by inference. Dental services billed under a covered medical contract are the clearer case.

## Self-funded (ERISA) plans

A self-funded private-employer (ERISA) dental plan is generally beyond a state prompt-pay statute's reach: 29 U.S.C. § 1144(b)(2)(B) bars a state from deeming such a plan an insurer, and the courts have read that to keep state insurance regulation off it. The statute itself never uses the words self-funded or prompt pay, and the rule is not categorical — a self-funded governmental or church plan is not an ERISA plan at all, so state law can reach it; § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law; and nothing in § 1144 addresses state enforcement against the third-party administrator or the network contract. Where the plan is a self-funded ERISA group health plan, the federal claims-procedure deadlines apply instead: a post-service benefit determination within 30 days (one 15-day extension), at least 180 days to appeal, and an appeal decision within 60 days (or two 30-day levels), under 29 CFR 2560.503-1.

## Also in the statute

- The Maimonides holding is about health care providers generally — the plaintiff was a hospital — not about dentistry specifically.
- The current text of §3224-a took effect September 19, 2025.

## Sources (statute text)

- [N.Y. Ins. Law §3224-a — New York State Senate (current revision)](https://www.nysenate.gov/legislation/laws/ISC/3224-A)
- [Maimonides Med. Ctr. v. First United Am. Life Ins. Co., 116 AD3d 207 (2d Dep't 2014)](https://www.nycourts.gov/reporter/3dseries/2014/2014_01441.htm)

## Related

- [All state prompt-pay pages](https://dentovio.com/dental-prompt-pay-laws/index.html.md)
- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Payer documentation requirements](https://dentovio.com/dental-claim-documentation/index.html.md)