senate Bill S6586

2013-2014 Legislative Session

Relates to Medicaid reviews and appeals

download bill text pdf

Sponsored By

Archive: Last Bill Status -


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Feb 10, 2014 referred to social services

S6586 - Details

Law Section:
Social Services Law
Laws Affected:
Amd §§22 & 365-a, Soc Serv L; amd §4403-f, Pub Health L

S6586 - Summary

Provides that enrollees are not required to exhaust Medicaid appeals prior to requesting a fair hearing.

S6586 - Sponsor Memo

S6586 - Bill Text download pdf

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

                                  6586

                            I N  S E N A T E

                            February 10, 2014
                               ___________

Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
  printed to be committed to the Committee on Social Services

AN ACT to amend the social services law and the public  health  law,  in
  relation to medicaid reviews and appeals

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

  Section 1. Section 22 of the social services law is amended by  adding
a new subdivision 15 to read as follows:
  15.  WITH  RESPECT TO MEDICAL ASSISTANCE UNDER TITLE ELEVEN OF ARTICLE
FIVE OF THIS CHAPTER, WHERE THE MEDICAL SERVICE AT ISSUE IS OR WOULD  BE
PROVIDED BY AN ENTITY SUBJECT TO ARTICLE FORTY-NINE OF THE PUBLIC HEALTH
LAW OR ARTICLE FORTY-NINE OF THE INSURANCE LAW:
  1.  AN  ENROLLEE SHALL NOT BE REQUIRED TO EXHAUST HIS OR HER REVIEW OR
APPEAL REMEDIES UNDER ARTICLE FORTY-NINE OF THE  PUBLIC  HEALTH  LAW  OR
ARTICLE FORTY-NINE OF THE INSURANCE LAW PRIOR TO REQUESTING A FAIR HEAR-
ING UNDER THIS SECTION OR ANY OTHER STATE OR FEDERAL LAW. HOWEVER, IN AN
APPROPRIATE  CASE,  THE HOLDING OR CONTINUING OF THE FAIR HEARING MAY BE
DELAYED PENDING THE OUTCOME OF SUCH REVIEW OR APPEAL.
  2. THE RIGHTS AND REMEDIES CONFERRED UNDER  THOSE  PROVISIONS  OF  THE
PUBLIC  HEALTH LAW OR THE INSURANCE LAW SHALL BE CUMULATIVE AND IN ADDI-
TION TO AND NOT IN LIEU OF ANY OTHER RIGHTS OR REMEDIES AVAILABLE  UNDER
LAW.
  S  2.  Subdivision  8  of section 365-a of the social services law, as
added by section 46-a of part B of chapter 58 of the laws  of  2009,  is
amended to read as follows:
  8.  When  a  non-governmental  entity  is authorized by the department
pursuant to contract or subcontract to make prior authorization or prior
approval determinations that may be required for  any  item  of  medical
assistance, a recipient may challenge any action taken or failure to act
in connection with a prior authorization or prior approval determination
as  if such determination were made by a government entity, and shall be
entitled to the same medical assistance benefits and  standards  and  to
the  same notice and procedural due process rights, including a right to
a fair hearing and aid continuing pursuant to section twenty-two of this

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

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