Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jun 19, 2014 |
referred to rules delivered to senate passed assembly ordered to third reading rules cal.435 rules report cal.435 |
Jun 18, 2014 |
reported reported referred to rules |
Jun 16, 2014 |
print number 3088c |
Jun 16, 2014 |
amend and recommit to insurance |
Jun 13, 2014 |
print number 3088b |
Jun 13, 2014 |
amend (t) and recommit to insurance |
Jan 08, 2014 |
referred to insurance |
Nov 20, 2013 |
print number 3088a |
Nov 20, 2013 |
amend and recommit to insurance |
Jan 23, 2013 |
referred to insurance |
Assembly Bill A3088C
2013-2014 Legislative Session
Sponsored By
LAVINE
Archive: Last Bill Status - In Senate Committee Rules 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
Actions
Bill Amendments
co-Sponsors
Vivian Cook
Carmen E. Arroyo
Janet Duprey
Vanessa Gibson
2013-A3088 - Details
2013-A3088 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3088 2013-2014 Regular Sessions I N A S S E M B L Y January 23, 2013 ___________ Introduced by M. of A. LAVINE, COOK, ARROYO, DUPREY, GIBSON, McKEVITT, MONTESANO, RIVERA, ROBERTS -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to recoveries of overpay- ments to health care providers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraphs 4 and 5 of subsection (b) of section 3224-b of the insurance law are renumbered paragraphs 5 and 6 and a new paragraph 4 is added to read as follows: (4) A HEALTH PLAN SHALL NOT DETERMINE AN OVERPAYMENT RECOVERY AMOUNT THROUGH THE USE OF EXTRAPOLATION, EXCEPT WHERE THERE IS EVIDENCE OF FRAUD OR INTENTIONAL MISCONDUCT. S 2. This act shall take effect immediately. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06450-01-3
co-Sponsors
Vivian Cook
Carmen E. Arroyo
Janet Duprey
Thomas McKevitt
multi-Sponsors
N. Nick Perry
2013-A3088A - Details
2013-A3088A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3088--A 2013-2014 Regular Sessions I N A S S E M B L Y January 23, 2013 ___________ Introduced by M. of A. LAVINE, COOK, ARROYO, DUPREY, GIBSON, McKEVITT, MONTESANO, RIVERA, ROBERTS, GOTTFRIED -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to recoveries of overpay- ments to health care providers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraphs 4 and 5 of subsection (b) of section 3224-b of the insurance law are renumbered paragraphs 5 and 6 and a new paragraph 4 is added to read as follows: (4) A HEALTH PLAN SHALL NOT DETERMINE AN OVERPAYMENT RECOVERY AMOUNT THROUGH THE USE OF EXTRAPOLATION, EXCEPT WHERE THERE IS EVIDENCE OF FRAUD OR INTENTIONAL MISCONDUCT. A FINDING OF OVERPAYMENT OR UNDERPAY- MENT MUST BE BASED ON THE ACTUAL OVERPAYMENT OR UNDERPAYMENT AND NOT AN EXTRAPOLATION OR PROJECTION BASED ON THE NUMBER OF PATIENTS SERVED OR ON THE NUMBER OF PATIENTS ENROLLED IN THAT NETWORK PROVIDER. S 2. This act shall take effect immediately. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06450-02-3
co-Sponsors
Vivian Cook
Carmen E. Arroyo
Janet Duprey
Thomas McKevitt
multi-Sponsors
N. Nick Perry
2013-A3088B - Details
2013-A3088B - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3088--B 2013-2014 Regular Sessions I N A S S E M B L Y January 23, 2013 ___________ Introduced by M. of A. LAVINE, COOK, ARROYO, DUPREY, McKEVITT, MONTESA- NO, RIVERA, ROBERTS, GOTTFRIED, SCHIMEL -- Multi-Sponsored by -- M. of A. PERRY -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to determination of over- payments to health care providers by extrapolation THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 2 of subsection (b) of section 3224-b of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (2) [A health plan shall provide a health care provider with the opportunity to challenge an overpayment recovery, including the sharing of claims information, and shall establish written policies and proce- dures for health care providers to follow to challenge an overpayment recovery. Such challenge shall set forth the specific grounds on which the provider is challenging the overpayment recovery] IN THE EVENT THAT THE PROCESS KNOWN AS EXTRAPOLATION WILL BE USED IN DETERMINING WHETHER HEALTH CARE PROVIDERS HAVE RECEIVED OVERPAYMENTS FROM A HEALTH CARE PLAN, THE HEALTH CARE PLAN SHALL COMPLY WITH THE FOLLOWING REQUIREMENTS: (A) ADVISE THE HEALTH CARE PROVIDER WITH WRITTEN NOTICE THAT EXTRAPO- LATION WILL BE UTILIZED; (B) APPLY A VALID STATISTICAL METHODOLOGY THAT USES STRATIFIED RANDOM SAMPLING METHODS TO ASSURE A FAIR EVALUATION OF THE CLAIMS SUBJECT TO AUDIT; (C) ADVISE THE HEALTH CARE PROVIDER AS TO THE TYPE OF METHODOLOGY USED; EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06450-05-4
co-Sponsors
Vivian Cook
Carmen E. Arroyo
Janet Duprey
Thomas McKevitt
multi-Sponsors
N. Nick Perry
2013-A3088C (ACTIVE) - Details
2013-A3088C (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3088--C 2013-2014 Regular Sessions I N A S S E M B L Y January 23, 2013 ___________ Introduced by M. of A. LAVINE, COOK, ARROYO, DUPREY, McKEVITT, MONTESA- NO, RIVERA, ROBERTS, GOTTFRIED, SCHIMEL -- Multi-Sponsored by -- M. of A. PERRY -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- again reported from said committee with amend- ments, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to determination of over- payments to health care providers by extrapolation THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 2 of subsection (b) of section 3224-b of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (2) A health plan shall provide a health care provider with the oppor- tunity to challenge an overpayment recovery, including the sharing of claims information, and shall establish written policies and procedures for health care providers to follow to challenge an overpayment recov- ery. Such challenge shall set forth the specific grounds on which the provider is challenging the overpayment recovery. IN THE EVENT THAT THE PROCESS KNOWN AS EXTRAPOLATION WILL BE USED IN DETERMINING WHETHER HEALTH CARE PROVIDERS HAVE RECEIVED OVERPAYMENTS FROM A HEALTH CARE PLAN, THE HEALTH CARE PLAN SHALL COMPLY WITH THE FOLLOWING REQUIREMENTS: (A) ADVISE THE HEALTH CARE PROVIDER WITH WRITTEN NOTICE THAT EXTRAPO- LATION WILL BE UTILIZED; (B) APPLY A VALID STATISTICAL METHODOLOGY THAT USES STRATIFIED RANDOM SAMPLING METHODS TO ASSURE A FAIR EVALUATION OF THE CLAIMS SUBJECT TO AUDIT; EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06450-06-4
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