Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Oct 26, 2015 |
signed chap.371 |
Oct 14, 2015 |
delivered to governor |
Jun 18, 2015 |
returned to assembly passed senate substituted for s4922a |
Jun 18, 2015 |
substituted by a1327a |
Jun 11, 2015 |
amended on third reading (t) 4922a |
Jun 02, 2015 |
advanced to third reading |
Jun 01, 2015 |
2nd report cal. |
May 28, 2015 |
1st report cal.1062 |
Apr 23, 2015 |
referred to health |
Senate Bill S4922A
Signed By Governor2015-2016 Legislative Session
Sponsored By
(R, C, IP) Senate District
Archive: Last Bill Status Via A1327 - Signed by Governor
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Votes
Bill Amendments
co-Sponsors
(R, C) Senate District
(D, IP) Senate District
2015-S4922 - Details
2015-S4922 - Sponsor Memo
BILL NUMBER:S4922 TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to requiring health maintenance organizations to cover court ordered health care services PURPOSE: This bill amends the Public Health Law and the Insurance Law related to court ordered services. SUMMARY OF PROVISIONS: Section 1 amends section 4406-c of the public health law to require that a health care plan reimburse health care services that are already a covered benefit of the plan if ordered by a court of competent jurisdic- tion, and an evaluation is performed by a plan's participating provider who certifies that such services are necessary and the services are provided by a participating health care provider. Sections 2 and 3 amend Sections 3217-b and 4325 of the Insurance Law, mirroring the Public Health Law provisions. Section 4 - Effective date.
2015-S4922 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 4922 2015-2016 Regular Sessions I N S E N A T E April 23, 2015 ___________ Introduced by Sen. HANNON -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law and the insurance law, in relation to requiring health maintenance organizations to cover court ordered health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 4406-c of the public health law is amended by adding a new subdivision 9 to read as follows: 9. A HEALTH CARE PLAN MUST COVER HEALTH CARE SERVICES ORDERED BY A COURT OF COMPETENT JURISDICTION ON THE BASIS OF AN EVALUATION PERFORMED BY A PHYSICIAN IF: (A) THE EVALUATION IS PERFORMED BY A PARTICIPATING PROVIDER WHO CERTI- FIES THAT FURTHER SERVICES ARE NECESSARY; (B) THE HEALTH CARE SERVICES THAT ARE THE SUBJECT OF THE PROSPECTIVE COURT ORDER ARE A COVERED BENEFIT OF THE HEALTH CARE PLAN; AND (C) THE HEALTH CARE SERVICES ARE TO BE PROVIDED BY A PARTICIPATING HEALTH CARE PROVIDER OF THE HEALTH CARE PLAN. ANY SUCH HEALTH CARE SERVICE SHALL NOT BE SUBJECT TO A SEPARATE MEDICAL NECESSITY DETERMINATION BY THE HEALTH CARE PLAN. S 2. Section 3217-b of the insurance law is amended by adding a new subsection (k) to read as follows: (K) A HEALTH CARE PLAN MUST COVER HEALTH CARE SERVICES ORDERED BY A COURT OF COMPETENT JURISDICTION ON THE BASIS OF AN EVALUATION PERFORMED BY A PHYSICIAN IF: (1) THE EVALUATION IS PERFORMED BY A PARTICIPATING PROVIDER WHO CERTI- FIES THAT FURTHER SERVICES ARE NECESSARY; (2) THE HEALTH CARE SERVICES THAT ARE THE SUBJECT OF THE PROSPECTIVE COURT ORDER ARE A COVERED BENEFIT OF THE HEALTH CARE PLAN; AND (3) THE HEALTH CARE SERVICES ARE TO BE PROVIDED BY A PARTICIPATING HEALTH CARE PROVIDER OF THE HEALTH CARE PLAN. ANY SUCH HEALTH CARE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06406-01-5
co-Sponsors
(R, C) Senate District
(R, C, IP) Senate District
(D, IP) Senate District
2015-S4922A (ACTIVE) - Details
2015-S4922A (ACTIVE) - Sponsor Memo
BILL NUMBER:S4922A TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to expedited utilization review of court ordered mental health and/or substance use disorder services PURPOSE: This bill amends the Public Health Law and the Insurance Law related to court ordered services. SUMMARY OF PROVISIONS: Section 1 amends section 4903 of the public health law to allow expedited utilization review for court ordered mental health and/or substance use disorder services. Sections 2 amends section 4904 of the public health law to allow expedited external appeal for court ordered mental health and/or substance use disorder services. Sections 3 and 4 make identical changes to the insurance law. Section 5 relates to the effective date. JUSTIFICATION: The bill would allow for expedited utilization review and expedited external appeals for court-ordered services. Specifically, for an individual with commercial health insurance
2015-S4922A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 4922--A Cal. No. 1062 2015-2016 Regular Sessions I N S E N A T E April 23, 2015 ___________ Introduced by Sens. HANNON, LARKIN, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- reported favorably from said committee, ordered to first and second report, ordered to a third reading, amended and ordered reprinted, retaining its place in the order of third reading AN ACT to amend the public health law and the insurance law, in relation to expedited utilization review of court ordered mental health and/or substance use disorder services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 2 of section 4903 of the public health law, as amended by section 22 of part H of chapter 60 of the laws of 2014, is amended to read as follows: 2. (A) A utilization review agent shall make a utilization review determination involving health care services which require pre-authori- zation and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within three business days of receipt of the necessary information. To the extent practicable, such written notification to the enrollee's health care provider shall be transmitted electronically, in a manner and in a form agreed upon by the parties. The notification shall identify; [(a)] (I) whether the services are considered in-network or out-of-network; [(b)] (II) and whether the enrollee will be held harmless for the services and not be responsible for any payment, other than any applicable co-payment or co-insurance; [(c)] (III) as applica- ble, the dollar amount the health care plan will pay if the service is out-of-network; and [(d)] (IV) as applicable, information explaining how an enrollee may determine the anticipated out-of-pocket cost for out-of- network health care services in a geographical area or zip code based upon the difference between what the health care plan will reimburse for EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06406-04-5
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