Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Oct 26, 2015 |
signed chap.371 |
Oct 14, 2015 |
delivered to governor |
Jun 18, 2015 |
returned to assembly passed senate substituted for s4922a |
Jun 17, 2015 |
referred to rules delivered to senate passed assembly |
Jun 11, 2015 |
amended on third reading (t) 1327a |
Jun 08, 2015 |
ordered to third reading rules cal.60 rules report cal.60 reported |
Jun 03, 2015 |
reported referred to rules |
Jan 09, 2015 |
referred to insurance |
Assembly Bill A1327
Signed By Governor2015-2016 Legislative Session
Sponsored By
CAHILL
Archive: Last Bill Status - Signed by Governor
- 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
Votes
Bill Amendments
co-Sponsors
Thomas Abinanti
2015-A1327 - Details
2015-A1327 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 1327 2015-2016 Regular Sessions I N A S S E M B L Y January 9, 2015 ___________ Introduced by M. of A. CAHILL -- read once and referred to the Committee on Insurance AN ACT to amend the public health law and the insurance law, in relation to requiring health maintenance organizations to cover court ordered health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 4406-c of the public health law is amended by adding a new subdivision 9 to read as follows: 9. A HEALTH CARE PLAN MUST COVER HEALTH CARE SERVICES ORDERED BY A COURT OF COMPETENT JURISDICTION ON THE BASIS OF AN EVALUATION PERFORMED BY A PHYSICIAN IF: (A) THE EVALUATION IS PERFORMED BY A PARTICIPATING PROVIDER WHO CERTI- FIES THAT FURTHER SERVICES ARE NECESSARY; (B) THE HEALTH CARE SERVICES THAT ARE THE SUBJECT OF THE PROSPECTIVE COURT ORDER ARE A COVERED BENEFIT OF THE HEALTH CARE PLAN; AND (C) THE HEALTH CARE SERVICES ARE TO BE PROVIDED BY A PARTICIPATING HEALTH CARE PROVIDER OF THE HEALTH CARE PLAN. ANY SUCH HEALTH CARE SERVICE SHALL NOT BE SUBJECT TO A SEPARATE MEDICAL NECESSITY DETERMINATION BY THE HEALTH CARE PLAN. S 2. Section 3217-b of the insurance law is amended by adding a new subsection (k) to read as follows: (K) A HEALTH CARE PLAN MUST COVER HEALTH CARE SERVICES ORDERED BY A COURT OF COMPETENT JURISDICTION ON THE BASIS OF AN EVALUATION PERFORMED BY A PHYSICIAN IF: (1) THE EVALUATION IS PERFORMED BY A PARTICIPATING PROVIDER WHO CERTI- FIES THAT FURTHER SERVICES ARE NECESSARY; (2) THE HEALTH CARE SERVICES THAT ARE THE SUBJECT OF THE PROSPECTIVE COURT ORDER ARE A COVERED BENEFIT OF THE HEALTH CARE PLAN; AND (3) THE HEALTH CARE SERVICES ARE TO BE PROVIDED BY A PARTICIPATING HEALTH CARE PROVIDER OF THE HEALTH CARE PLAN. ANY SUCH HEALTH CARE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06406-01-5
co-Sponsors
Thomas Abinanti
2015-A1327A (ACTIVE) - Details
2015-A1327A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 1327--A R. R. 60 2015-2016 Regular Sessions I N A S S E M B L Y January 9, 2015 ___________ Introduced by M. of A. CAHILL, ABINANTI -- read once and referred to the Committee on Insurance -- reported and referred to the Committee on Rules -- amended on the special order of third reading, ordered reprinted as amended, retaining its place on the special order of third reading AN ACT to amend the public health law and the insurance law, in relation to expedited utilization review of court ordered mental health and/or substance use disorder services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 2 of section 4903 of the public health law, as amended by section 22 of part H of chapter 60 of the laws of 2014, is amended to read as follows: 2. (A) A utilization review agent shall make a utilization review determination involving health care services which require pre-authori- zation and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within three business days of receipt of the necessary information. To the extent practicable, such written notification to the enrollee's health care provider shall be transmitted electronically, in a manner and in a form agreed upon by the parties. The notification shall identify; [(a)] (I) whether the services are considered in-network or out-of-network; [(b)] (II) and whether the enrollee will be held harmless for the services and not be responsible for any payment, other than any applicable co-payment or co-insurance; [(c)] (III) as applica- ble, the dollar amount the health care plan will pay if the service is out-of-network; and [(d)] (IV) as applicable, information explaining how an enrollee may determine the anticipated out-of-pocket cost for out-of- network health care services in a geographical area or zip code based upon the difference between what the health care plan will reimburse for EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06406-05-5
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