Senate Bill S7161

2011-2012 Legislative Session

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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Archive: Last Bill Status - In Assembly Committee


  • 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

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2011-S7161 (ACTIVE) - Details

Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd §2559, Pub Health L

2011-S7161 (ACTIVE) - 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.

2011-S7161 (ACTIVE) - Sponsor Memo

2011-S7161 (ACTIVE) - Bill Text download pdf

                            
                    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
              

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