senate Bill S160

2011-2012 Legislative Session

Establishes procedures for the collection of overpayments from health care providers

download bill text pdf

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Archive: Last Bill Status - In Senate Committee


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

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Actions

view actions (2)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 04, 2012 referred to insurance
Jan 05, 2011 referred to insurance

S160 - Details

Law Section:
Insurance Law
Laws Affected:
Amd §§3224-a, 4803 & 3217-b, Ins L; amd §§4406-c & 4406-d, Pub Health L
Versions Introduced in 2009-2010 Legislative Session:
S311

S160 - Summary

Establishes procedures for the collection of overpayments from health care providers; requires insurers to notify health care professionals regarding billing codes; and requires certain contracts entered into with health care providers to include certain information.

S160 - Sponsor Memo

S160 - Bill Text download pdf

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

                                   160

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by  Sen. MAZIARZ -- read twice and ordered printed, and when
  printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law and the public health law, in relation
  to establishing procedures for the  collection  of  overpayments  from
  health  care  providers  based  upon  eligibility  of the insured; and
  requiring insurers to notify health care professionals by written  and
  electronic  formats  regarding particular billing codes; and requiring
  contracts entered into with a health care provider to include  certain
  information

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

  Section 1. Section 3224-a of the insurance law is amended by adding  a
new subsection (b-1) to read as follows:
  (B-1)  WHERE  AN INSURER OR ORGANIZATION OR CORPORATION SEEKS A REFUND
FROM A HEALTH CARE PROVIDER OF A PAYMENT PREVIOUSLY MADE FOR HEALTH CARE
SERVICES:
  (1) IN A CASE WHERE AN INSURER OR ORGANIZATION OR CORPORATION IS SEEK-
ING A REFUND FOR PAYMENT PREVIOUSLY MADE BASED UPON A GOOD FAITH  BELIEF
REGARDING  THE ELIGIBILITY OF A PERSON FOR COVERAGE, OR THE LIABILITY OF
ANOTHER INSURER OR CORPORATION OR ORGANIZATION FOR ALL OR  PART  OF  THE
CLAIM, THE INSURER OR ORGANIZATION OR CORPORATION MUST NOTIFY THE HEALTH
CARE  PROVIDER  IN  WRITING  THE  AMOUNT OF THE REFUND BEING SOUGHT, THE
SPECIFIC REASONS WHY THE REFUND IS BEING SOUGHT, AND ANY INFORMATION  IT
MAY  HAVE  REGARDING ANOTHER INSURER, ORGANIZATION, CORPORATION OR OTHER
ENTITY THAT MAY BE LEGALLY OBLIGATED TO MAKE PAYMENT.  IF  THE  INSURER,
ORGANIZATION  OR  CORPORATION  SEEKING  THE REFUND DOES NOT MAINTAIN ANY
SUCH INFORMATION, IT SHALL SO STATE ON THE NOTICE  TO  THE  HEALTH  CARE
PROVIDER.  NOTICE OF SUCH REFUND DEMAND SHALL BE MADE AS SOON AS REASON-
ABLY PRACTICABLE AFTER RECEIPT OF INFORMATION THAT SUCH INSURER,  ORGAN-
IZATION OR CORPORATION WAS NOT RESPONSIBLE FOR PAYMENT. FAILURE TO IDEN-

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

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