S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2934

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 25, 2013
                               ___________

Introduced by Sens. HANNON, RANZENHOFER -- read twice and ordered print-
  ed, and when printed to be committed to the Committee on Health

AN  ACT  to  amend  the  social  services  law, in relation to a medical
  assistance information and payment system

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph 2 of paragraph (b) of subdivision 8 of section
367-b  of the social services law, as amended by chapter 109 of the laws
of 2007, is amended to read as follows:
  (2) Coordination of benefits. Develop, test and implement an automated
process to improve the coordination  of  benefits  between  the  medical
assistance  program and other sources of coverage for medical assistance
recipients. Such initiative shall initially examine the  savings  poten-
tial  to  the medical assistance program through retrospective review of
claims paid which shall be completed  not  later  than  January  thirty-
first,  two  thousand seven. If, based upon such initial experience, the
Medicaid inspector general deems the automated process to be capable  of
including  or  moving to a prospective review, with negligible effect on
the turnaround of claims for provider payment or on recipient access  to
services,  then the Medicaid inspector general in subsequent tests shall
examine the savings potential through  prospective,  pre-claims  payment
review.    PROVIDED, HOWEVER, THAT THE DEPARTMENT OF HEALTH SHALL IMPLE-
MENT AN INITIATIVE ESTABLISHING AN AUTOMATED REAL TIME PROSPECTIVE  PRE-
CLAIMS  PAYMENT  REVIEW  PROCESS, INCLUDING, BUT NOT LIMITED TO, A PRIOR
PHARMACY AUTHORIZATION AND PRE-PHARMACY  CLAIMS  REVIEW  OF  ALTERNATIVE
INSURANCE  COVERAGE  PROGRAM,  PROVIDED HOWEVER THAT ANY SUCH INITIATIVE
HAS MINIMAL INITIAL COSTS TO THE DEPARTMENT OF  HEALTH.  ANY  INITIATIVE
IMPLEMENTED  BY  THE DEPARTMENT OF HEALTH SHALL HAVE A NEGLIGIBLE EFFECT
ON THE TURNAROUND OF CLAIMS FOR PROVIDER PAYMENT OR ON RECIPIENT  ACCESS
TO SERVICES AND DEMONSTRATE SAVINGS POTENTIAL.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05787-01-3

              

S. 2934                             2

  S  2. The department of health shall issue a request for proposals for
the purpose of providing the system described  in  subparagraph  (2)  of
paragraph  (b)  of subdivision 8 of section 367-b of the social services
law, as amended by section one of this act, within 90 days of the effec-
tive  date of this act. Bids from qualified vendors shall be received by
the department of health no later than 60 days following the issuance of
the request for proposals. Any contract issued pursuant to this  section
shall  be  issued within 90 days following receipt of bids and installa-
tion of such system completed by the successful bidder within  180  days
of the issuance of such contract.
  S 3. This act shall take effect immediately.