| Assembly Actions - Lowercase Senate Actions - UPPERCASE |
|
|---|---|
| Jun 16, 2016 | referred to rules delivered to senate passed assembly |
| Jun 15, 2016 | ordered to third reading rules cal.415 rules report cal.415 reported |
| Jun 01, 2016 | reported referred to rules |
| May 19, 2016 | print number 10268a |
| May 19, 2016 | amend (t) and recommit to insurance referred to insurance |
Archive: Last Bill Status - Passed Assembly
- Introduced
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
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Bill Amendments
A10268 - Details
A10268 - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
10268
I N A S S E M B L Y
May 19, 2016
___________
Introduced by M. of A. HUNTER -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to preventing plans from
denying treatment due to lack of pre-authorization
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3238 of the insurance law is amended by adding a
new subsection (c-1) to read as follows:
(C-1) IF A HEALTH PLAN DENIES PAYMENT FOR THE TREATMENT OF CONCURRENT
SYMPTOMS OR SIDE EFFECTS DUE TO LACK OF PRE-AUTHORIZATION AND SUCH
TREATMENT IS RENDERED AT THE SAME TIME AS A HEALTH CARE SERVICE FOR
WHICH PRE-AUTHORIZATION WAS REQUIRED AND RECEIVED, UPON THE APPEAL OF
THE THE DENIAL, THE DENIAL OF ANY SUCH SERVICE SHALL BE UPHELD ONLY IF
IT IS DETERMINED THAT:
(1) THE TREATMENT IS NOT A COVERED BENEFIT;
(2) THE TREATMENT WAS NOT MEDICALLY NECESSARY PURSUANT TO SECTION FOUR
THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER OR SECTION FOUR THOUSAND NINE
HUNDRED FOUR OF THE PUBLIC HEALTH LAW;
(3) THE TREATMENT WAS EXPERIMENTAL OR INVESTIGATIONAL PURSUANT TO
SECTION FOUR THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER OR SECTION FOUR
THOUSAND NINE HUNDRED FOUR OF THE PUBLIC HEALTH LAW; OR
(4) ON OF THE CONDITIONS SET FORTH IN PARAGRAPHS ONE THROUGH SIX OF
SUBSECTION (A) OF THIS SECTION IS MET.
S 2. This act shall take effect immediately.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15457-02-6
A10268A (ACTIVE) - Details
A10268A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
10268--A
I N A S S E M B L Y
May 19, 2016
___________
Introduced by M. of A. HUNTER -- 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 denial of coverage of
treatment related to health care services for which pre-authorization
was granted
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3238 of the insurance law is amended by adding a
new subsection (c-1) to read as follows:
(C-1) IF A HEALTH PLAN DENIES PAYMENT FOR THE TREATMENT OF CONCURRENT
SYMPTOMS OR SIDE EFFECTS DUE TO LACK OF PRE-AUTHORIZATION AND SUCH
TREATMENT IS RENDERED AT THE SAME TIME AS A HEALTH CARE SERVICE FOR
WHICH PRE-AUTHORIZATION WAS REQUIRED AND RECEIVED, UPON THE APPEAL OF
THE DENIAL, THE DENIAL OF ANY SUCH SERVICE SHALL BE UPHELD ONLY IF IT IS
DETERMINED THAT:
(1) THE TREATMENT IS NOT A COVERED BENEFIT;
(2) THE TREATMENT WAS NOT MEDICALLY NECESSARY PURSUANT TO SECTION FOUR
THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER OR SECTION FORTY-NINE HUNDRED
FOUR OF THE PUBLIC HEALTH LAW;
(3) THE TREATMENT WAS EXPERIMENTAL OR INVESTIGATIONAL PURSUANT TO
SECTION FOUR THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER OR SECTION
FORTY-NINE HUNDRED FOUR OF THE PUBLIC HEALTH LAW; OR
(4) ONE OF THE CONDITIONS SET FORTH IN PARAGRAPHS ONE THROUGH SIX OF
SUBSECTION (A) OF THIS SECTION IS MET.
S 2. This act shall take effect on the ninetieth day after it shall
have become a law.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15457-03-6