senate Bill S7161

Requires the fiscal agent of the department of health to seek payments to providers of evaluations and early intervention services provided to children

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 01 / May / 2012
    • REFERRED TO HEALTH
  • 15 / May / 2012
    • 1ST REPORT CAL.822
  • 16 / May / 2012
    • 2ND REPORT CAL.
  • 21 / May / 2012
    • ADVANCED TO THIRD READING
  • 05 / Jun / 2012
    • PASSED SENATE
  • 05 / Jun / 2012
    • DELIVERED TO ASSEMBLY
  • 05 / Jun / 2012
    • REFERRED TO HEALTH

Summary

Requires the fiscal agent of the department of health to seek payments from third party payors, to providers of evaluations and early interventions services provided to children.

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Bill Details

Versions:
S7161
Legislative Cycle:
2011-2012
Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd ยง2559, Pub Health L

Sponsor Memo

BILL NUMBER:S7161

TITLE OF BILL:

An act
to amend the public health law, in relation to payments to providers of
evaluations and early intervention services to children

PURPOSE:

To make technical, clarifying amendments to provision adopted in the
2012-13 budget relating to the use of a fiscal agent in the Early
Intervention Services Program.

SUMMARY OF PROVISIONS:
Section 1 of the bill amends paragraph (a) of subdivision 3 of Section
2559 of the public health law to clarify that Early Intervention
provides are not required to seek payment from third party payers
but instead shall submit all claims through the fiscal agent who
shall seek payment.

Section 2 of the bill provides the effective date.

JUSTIFICATION:
This bill makes technical clarifying amendments to provisions adopted
in the 2012-13 budget to ensure that EI provides are not required to
directly bill third party venders and local governments. The intent
of creating a fiscal agent was to have all bills funnel through one
entity responsible for seeking reimbursement from third party
insurance so that the process is more efficient and effective than
having each county seeking payments as has been the practice under
the EI program.

This bill merely makes the technical changes to clarify the intent of
recently adopted budget language.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This act shall take effect on the same date and in the same manner as
section 11 of part A of chapter 56 of the laws of 2012, takes effect.

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

                                  7161

                            I N  S E N A T E

                               May 1, 2012
                               ___________

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,  in  relation  to  payments  to
  providers of evaluations and early intervention services to children

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

  Section 1. Paragraph (a) of subdivision  3  of  section  2559  of  the
public  health  law, as amended by section 11 of part A of chapter 56 of
the laws of 2012, is amended to read as follows:
  (a) Providers of evaluations and early intervention services,  herein-
after  collectively  referred  to  in  this subdivision as "provider" or
"providers", shall [in the first instance  and  where  applicable,  seek
payment  from  all  third  party  payors including governmental agencies
prior to claiming payment from a given municipality] SUBMIT  ALL  CLAIMS
for evaluations conducted under the program and for services rendered to
eligible  children[,  provided  that, the] THROUGH THE FISCAL AGENT. THE
FISCAL AGENT SHALL BE RESPONSIBLE FOR SEEKING  PAYMENT  FROM  ALL  THIRD
PARTY  PAYORS,  INCLUDING  GOVERNMENTAL AGENCIES. THE obligation to seek
payment shall not apply to a payment from a third party payor who is not
prohibited from applying such payment, and will apply such  payment,  to
an annual or lifetime limit specified in the insured's policy.
  (i)  Parents  shall  provide  the municipality and service coordinator
information on any insurance policy, plan or  contract  under  which  an
eligible child has coverage.
  (ii)  Parents shall provide the municipality and the service coordina-
tor with a written referral from a primary care provider  as  documenta-
tion,  for  eligible  children, of the medical necessity of early inter-
vention services.
  (iii) providers shall utilize the department's fiscal agent  and  data
system  for [claiming payment] SUBMISSION OF CLAIMS FOR PAYMENT, INCLUD-
ING THIRD PARTY PAYORS, for evaluations and services rendered under  the
early intervention program.
  S  2.  This  act  shall  take  effect on the same date and in the same
manner as section 11 of part A of chapter 56 of the laws of 2012,  takes
effect.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15556-02-2

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