senate Bill S4138B

2011-2012 Legislative Session

Requires reimbursement for surgical first assistant services

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Archive: Last Bill Status - In 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 (10)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
May 16, 2012 print number 4138b
amend and recommit to insurance
Jan 11, 2012 print number 4138a
amend and recommit to insurance
Jan 04, 2012 referred to insurance
Jun 24, 2011 committed to rules
Jun 06, 2011 advanced to third reading
Jun 02, 2011 2nd report cal.
Jun 01, 2011 1st report cal.897
Mar 21, 2011 referred to insurance

Bill Amendments

Original
A
B (Active)
Original
A
B (Active)

Co-Sponsors

S4138 - Details

See Assembly Version of this Bill:
A10178
Current Committee:
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §§365-a & 369-ee, Soc Serv L; amd §13, Work Comp L
Versions Introduced in Previous Legislative Sessions:
2011-2012: A10178
2009-2010: A5720C

S4138 - Summary

Requires reimbursement for surgical first assistant services.

S4138 - Sponsor Memo

S4138 - Bill Text download pdf

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

                                  4138

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 21, 2011
                               ___________

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

AN ACT to amend the insurance law, the social services law and the work-
  ers' compensation law, in relation to reimbursement for surgical first
  assistant services

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

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 28 to read as follows:
  (28) EVERY POLICY ISSUED  PURSUANT  TO  THIS  SECTION  WHICH  PROVIDES
REIMBURSEMENT  FOR  NON-PHYSICIAN SURGICAL FIRST ASSISTANT SERVICES WHEN
SUCH SERVICES ARE PROVIDED BY A NON-PHYSICIAN SURGICAL  FIRST  ASSISTANT
WHO  IS EMPLOYED BY A PHYSICIAN AND THE PHYSICIAN BILLS FOR THE SERVICES
SHALL NOT DENY SUCH COVERAGE EXCLUSIVELY ON THE BASIS THAT THE  NON-PHY-
SICIAN  SURGICAL FIRST ASSISTANT SERVICES WERE PERFORMED BY A REGISTERED
NURSE FIRST  ASSISTANT  WHO  IS  CERTIFIED  IN  OPERATING  ROOM  NURSING
PROVIDED  THAT:  (A) SUCH SERVICES ARE WITHIN THE SCOPE OF PRACTICE OF A
NON-PHYSICIAN SURGICAL FIRST ASSISTANT; AND (B) THE TERMS AND CONDITIONS
OF THE MEMBER CONTRACT  OTHERWISE  PROVIDE  FOR  THE  COVERAGE  OF  SUCH
SERVICES.  NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO:  PREVENT THE
MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF  SUCH  SERVICES;  PREVENT  A
POLICY  FROM  REQUIRING  SERVICES  THROUGH  A  NETWORK  OF PARTICIPATING
PROVIDERS WHO SHALL MEET CERTAIN REQUIREMENTS FOR PARTICIPATION, INCLUD-
ING PROVIDER CREDENTIALING; OR PROHIBIT AN INSURER  FROM,  IN  ITS  SOLE
DISCRETION,  PROVIDING  A  GLOBAL  OR  CAPITATED  PAYMENT OR ELECTING TO
DIRECTLY REIMBURSE A NON-PHYSICIAN SURGICAL  FIRST  ASSISTANT  FOR  SUCH
SERVICES.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 17 to read as follows:
  (17)  EVERY  POLICY  ISSUED  PURSUANT  TO  THIS SECTION WHICH PROVIDES
REIMBURSEMENT FOR NON-PHYSICIAN SURGICAL FIRST ASSISTANT  SERVICES  WHEN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01171-01-1

Co-Sponsors

S4138A - Details

See Assembly Version of this Bill:
A10178
Current Committee:
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §§365-a & 369-ee, Soc Serv L; amd §13, Work Comp L
Versions Introduced in Previous Legislative Sessions:
2011-2012: A10178
2009-2010: A5720C

S4138A - Summary

Requires reimbursement for surgical first assistant services.

S4138A - Sponsor Memo

S4138A - Bill Text download pdf

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

                                 4138--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 21, 2011
                               ___________

Introduced  by  Sens. LITTLE, MAZIARZ -- read twice and ordered printed,
  and when printed to be committed to  the  Committee  on  Insurance  --
  recommitted  to  the  Committee on Insurance in accordance with Senate
  Rule  6,  sec.  8  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the insurance law, the social services law and the work-
  ers' compensation law, in relation to reimbursement for surgical first
  assistant services

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

  Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
amended by adding a new paragraph 29 to read as follows:
  (29)  EVERY  POLICY  ISSUED  PURSUANT  TO  THIS SECTION WHICH PROVIDES
REIMBURSEMENT FOR NON-PHYSICIAN SURGICAL FIRST ASSISTANT  SERVICES  WHEN
SUCH  SERVICES  ARE PROVIDED BY A NON-PHYSICIAN SURGICAL FIRST ASSISTANT
WHO IS EMPLOYED BY A PHYSICIAN AND THE PHYSICIAN BILLS FOR THE  SERVICES
SHALL  NOT DENY SUCH COVERAGE EXCLUSIVELY ON THE BASIS THAT THE NON-PHY-
SICIAN SURGICAL FIRST ASSISTANT SERVICES WERE PERFORMED BY A  REGISTERED
NURSE  FIRST  ASSISTANT  WHO  IS  CERTIFIED  IN  OPERATING  ROOM NURSING
PROVIDED THAT: (A) SUCH SERVICES ARE WITHIN THE SCOPE OF PRACTICE  OF  A
NON-PHYSICIAN SURGICAL FIRST ASSISTANT; AND (B) THE TERMS AND CONDITIONS
OF  THE  MEMBER  CONTRACT  OTHERWISE  PROVIDE  FOR  THE COVERAGE OF SUCH
SERVICES. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO:  PREVENT  THE
MEDICAL  MANAGEMENT  OR  UTILIZATION  REVIEW OF SUCH SERVICES; PREVENT A
POLICY FROM  REQUIRING  SERVICES  THROUGH  A  NETWORK  OF  PARTICIPATING
PROVIDERS WHO SHALL MEET CERTAIN REQUIREMENTS FOR PARTICIPATION, INCLUD-
ING  PROVIDER  CREDENTIALING;  OR  PROHIBIT AN INSURER FROM, IN ITS SOLE
DISCRETION, PROVIDING A GLOBAL  OR  CAPITATED  PAYMENT  OR  ELECTING  TO
DIRECTLY  REIMBURSE  A  NON-PHYSICIAN  SURGICAL FIRST ASSISTANT FOR SUCH
SERVICES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01171-02-2

Co-Sponsors

S4138B (ACTIVE) - Details

See Assembly Version of this Bill:
A10178
Current Committee:
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §§365-a & 369-ee, Soc Serv L; amd §13, Work Comp L
Versions Introduced in Previous Legislative Sessions:
2011-2012: A10178
2009-2010: A5720C

S4138B (ACTIVE) - Summary

Requires reimbursement for surgical first assistant services.

S4138B (ACTIVE) - Sponsor Memo

S4138B (ACTIVE) - Bill Text download pdf

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

                                 4138--B

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 21, 2011
                               ___________

Introduced  by  Sens. LITTLE, MAZIARZ -- read twice and ordered printed,
  and when printed to be committed to  the  Committee  on  Insurance  --
  recommitted  to  the  Committee on Insurance in accordance with Senate
  Rule  6,  sec.  8  --  committee  discharged,  bill  amended,  ordered
  reprinted  as  amended  and recommitted to said committee -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the insurance law, the social services law and the work-
  ers' compensation law, in relation to reimbursement for surgical first
  assistant services

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

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 29 to read as follows:
  (29) EVERY POLICY ISSUED  PURSUANT  TO  THIS  SECTION  WHICH  PROVIDES
REIMBURSEMENT  FOR  NON-PHYSICIAN SURGICAL FIRST ASSISTANT SERVICES WHEN
SUCH SERVICES ARE PROVIDED BY A NON-PHYSICIAN SURGICAL  FIRST  ASSISTANT
WHO  IS EMPLOYED BY A PHYSICIAN AND THE PHYSICIAN BILLS FOR THE SERVICES
SHALL NOT DENY SUCH COVERAGE EXCLUSIVELY ON THE BASIS THAT THE  NON-PHY-
SICIAN  SURGICAL FIRST ASSISTANT SERVICES WERE PERFORMED BY A REGISTERED
NURSE FIRST  ASSISTANT  WHO  IS  CERTIFIED  IN  OPERATING  ROOM  NURSING
PROVIDED  THAT:  (A) SUCH SERVICES ARE WITHIN THE SCOPE OF PRACTICE OF A
NON-PHYSICIAN SURGICAL FIRST ASSISTANT; AND (B) THE TERMS AND CONDITIONS
OF THE MEMBER CONTRACT  OTHERWISE  PROVIDE  FOR  THE  COVERAGE  OF  SUCH
SERVICES.  NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO:  PREVENT THE
MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF  SUCH  SERVICES;  PREVENT  A
POLICY  FROM  REQUIRING  SERVICES  THROUGH  A  NETWORK  OF PARTICIPATING
PROVIDERS WHO SHALL MEET CERTAIN REQUIREMENTS FOR PARTICIPATION, INCLUD-
ING PROVIDER CREDENTIALING; OR PROHIBIT AN INSURER  FROM,  IN  ITS  SOLE
DISCRETION,  PROVIDING  A  GLOBAL  OR  CAPITATED  PAYMENT OR ELECTING TO

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01171-03-2

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