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Assembly Bill A8892

2011-2012 Legislative Session

Relates to overpayments to health care providers when fraud or other intentional misconduct is alleged

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Archive: Last Bill Status - In Assembly Committee

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2011-A8892 (ACTIVE) - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd ยง3224-b, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A9720, A3342

2011-A8892 (ACTIVE) - Summary

Relates to overpayments to health care providers when fraud or other intentional misconduct is alleged.

2011-A8892 (ACTIVE) - Bill Text download pdf 

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

                                  8892

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 4, 2012
                               ___________

Introduced  by M. of A. QUART -- read once and referred to the Committee
  on Insurance

AN ACT to amend the insurance law, in relation to overpayments to health
  care providers

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

  Section  1.  Subsection  (b) of section 3224-b of the insurance law is
amended by adding a new paragraph 2-a to read as follows:
  (2-A) IF A HEALTH CARE PLAN ALLEGES FRAUD OR OTHER INTENTIONAL MISCON-
DUCT, OR ABUSIVE BILLING TO SEEK RECOVERY OF AN OVERPAYMENT PURSUANT  TO
PARAGRAPH  TWO OF THIS SUBSECTION MORE THAN TWENTY-FOUR MONTHS AFTER THE
ORIGINAL PAYMENT WAS RECEIVED BY THE HEALTH CARE  PROVIDER,  AND  IT  IS
FOUND  THAT  SUCH  PAYMENT OR PAYMENTS IN DISPUTE WERE NOT THE RESULT OF
FRAUD OR OTHER INTENTIONAL MISCONDUCT OR ABUSIVE  BILLING,  SUCH  HEALTH
CARE PLAN SHALL BE RESPONSIBLE FOR THE REASONABLE LEGAL AND OTHER EXPERT
FEES OF THE HEALTH CARE PROVIDER CONNECTED WITH THE DEFENSE OF THE ALLE-
GATIONS  THAT  THERE  WAS  AN OVERPAYMENT. THE DEPARTMENT SHALL FINE ANY
HEALTH CARE PLAN FOUND TO HAVE KNOWINGLY, WILLFULLY OR  RECKLESSLY  MADE
FALSE  CHARGES  UNDER  THIS  SECTION IN AN AMOUNT OF UP TO FIVE THOUSAND
DOLLARS PER PAYMENT THAT IS FALSELY CHARGED TO HAVE BEEN THE  RESULT  OF
FRAUD OR OTHER INTENTIONAL MISCONDUCT OR ABUSIVE BILLING.
  S 2. This act shall take effect immediately.




 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08055-03-2

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