| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Apr 19, 2010 |
referred to health |
Senate Bill S7520
2009-2010 Legislative Session
Sponsored By
(R, C, IP) Senate District
Archive: Last Bill Status - In Senate Committee Health Committee
Actions
co-Sponsors
(R, C) Senate District
(R) Senate District
(R) Senate District
(R, C, IP) Senate District
2009-S7520 (ACTIVE) - Details
- See Assembly Version of this Bill:
- A8909
- Current Committee:
- Senate Health
- Law Section:
- Social Services Law
- Laws Affected:
- Amd ยง367-b, Soc Serv L
- Versions Introduced in Other Legislative Sessions:
-
2011-2012:
S379, A961
2013-2014: S2934
2009-S7520 (ACTIVE) - Sponsor Memo
BILL NUMBER: S7520
TITLE OF BILL :
An act to amend the social services law, in relation to a medical
assistance information and payment system
PURPOSE OR GENERAL IDEA OF BILL :
To provide a more cost effective and efficient method to determine the
third party eligibility of Medicaid claims for prescription drugs,
while at the same time generating hundreds of millions of dollars for
New York State taxpayers.
SUMMARY OF SPECIFIC PROVISIONS :
Section one of the bill directs the department of health to implement
an initiative establishing an automated real time prospective pre
claims payment review process.
Section two of the bill directs the Department to issue an RFP within
ninety days of the effective date.
Section three of the bill provides for an immediate effective date.
JUSTIFICATION :
Under the existing system, Medicaid provides initial coverage for
prescription drugs and later determines a patient's eligibility for
2009-S7520 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
7520
I N S E N A T E
April 19, 2010
___________
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 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.
S 2. The department of health shall issue a request for proposal 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-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
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