How does subrogation work?
Section 2559(d) of PHL and 10 NYCRR 69-4.22(b) subrogate the municipality or its designee to any rights an eligible child and his or her family may have or be entitled to from third party reimbursement for services covered in their insurance plan to the extent of expenditures by the municipality for early intervention services provided to the child or family. Section 3235-a(c) of the Insurance Law states that a right of subrogation exercised by a municipality under Section 2559 of the Public Health Law is valid and enforceable against the commercial insurer to the extent benefits are available under the insurance policy. This means that the health insurer must accept claims submitted by a municipality, with prior written notice of intent to exercise subrogation rights, for early intervention services paid by the municipality for an eligible child and for which benefits are available to the insured child. Upon notification by an initial service coordinator of the child’s eligibility for
