Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Apr 27, 2010 |
enacting clause stricken |
Jan 20, 2010 |
committed to health |
Jan 06, 2010 |
ordered to third reading cal.18 returned to assembly died in senate |
Jul 16, 2009 |
committed to rules |
May 26, 2009 |
3rd reading cal.377 substituted for s3840 |
Jan 06, 2010 |
referred to health |
May 26, 2009 |
substituted by a301 advanced to third reading |
May 20, 2009 |
2nd report cal. |
May 19, 2009 |
1st report cal.377 |
May 05, 2009 |
reported and committed to finance |
Apr 02, 2009 |
referred to health |
Senate Bill S3840
2009-2010 Legislative Session
Sponsored By
(D, WF) Senate District
Archive: Last Bill Status Via A301 - Stricken
- 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
2009-S3840 (ACTIVE) - Details
- Current Committee:
- Senate Health
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §§4900, 4905, 4910 & 4914, Pub Health L; amd §§4900, 4905, 4910 & 4914, Ins L
2009-S3840 (ACTIVE) - Sponsor Memo
BILL NUMBER: S3840 TITLE OF BILL : An act to amend the public health law and the insurance law, in relation to protocol for treatment of rare disease PURPOSE : To establish evidentiary standards for utilization review (UR) and external appeal when determining whether to pay for a rare disease treatment. SUMMARY OF PROVISIONS : Section 1 of the bill amends PHI. §4900 to define rare disease treatment for disabling and life-threatening conditions and diseases, referencing federal guidelines. Sections 2 and 4 amend PHL §§ 4905 and 4914 to establish evidentiary standards for utilization review (UR) and external appeal when determining whether to pay for a rare disease treatment, using the standard already in law for treatments under federally approved clinical trials:; "likely to benefit" the patient, providing that the treatment is not excluded from coverage for other reasons.
2009-S3840 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3840 2009-2010 Regular Sessions I N S E N A T E April 2, 2009 ___________ Introduced by Sen. DUANE -- 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 protocol for treatment of rare disease THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 4900 of the public health law is amended by adding a new subdivision 11 to read as follows: 11. "RARE DISEASE TREATMENT" MEANS A TREATMENT OR SERVICE ADMINISTERED TO AN ENROLLEE WITH A RARE DISABLING OR LIFE-THREATENING CONDITION OR DISEASE WHICH IS LISTED AS A RARE DISEASE BY THE NATIONAL INSTITUTES OF HEALTH OFFICE OF RARE DISEASES OR IS ELIGIBLE FOR SUCH LISTING UNDER THE FEDERAL RARE DISEASES ACT OF 2002. S 2. Section 4905 of the public health law is amended by adding a new subdivision 16 to read as follows: 16. WHEN MAKING DETERMINATIONS IN RELATION TO RARE DISEASE TREATMENT, THE UTILIZATION REVIEW AGENT SHALL REVIEW MEDICAL AND SCIENTIFIC EVIDENCE RELATING TO CONDITIONS OR DISEASES OF HIGHER PREVALENCE IN THE SAME CLASS OR CATEGORY, DETERMINED BY THE REVIEW AGENT TO BE COMPARABLE TO THE RARE DISEASE, AS WELL AS MEDICAL AND SCIENTIFIC EVIDENCE RELATING TO THE RARE DISEASE, IN ORDER TO DETERMINE WHETHER THE TREATMENT IS LIKELY TO BENEFIT THE PATIENT, IF THE SPECIFIC HEALTH TREATMENT OR SERVICE RECOMMENDED BY THE HEALTH CARE PROFESSIONAL WOULD NOT OTHERWISE BE EXCLUDED FROM COVERAGE UNDER THE POLICY ON GROUNDS OTHER THAN MEDICAL NECESSITY OR EXPERIMENTAL TREATMENT. S 3. Subparagraphs (ii) and (iii) of paragraph (b) of subdivision 2 of section 4910 of the public health law, as added by chapter 586 of the laws of 1998, are amended to read as follows: (ii) the enrollee's attending physician has certified that the enrol- lee has a life-threatening or disabling condition or disease (a) for which standard health services or procedures have been ineffective or EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01759-01-9
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