assembly Bill A445A

2015-2016 Legislative Session

Relates to the definition of a clinical peer reviewer

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Archive: Last Bill Status - On Floor Calendar


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

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Actions

view actions (7)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 28, 2016 advanced to third reading cal.346
Jan 26, 2016 reported
Jan 06, 2016 referred to health
Apr 28, 2015 amended on third reading 445a
Feb 05, 2015 advanced to third reading cal.5
Feb 03, 2015 reported
Jan 07, 2015 referred to health

Co-Sponsors

view additional co-sponsors

A445 - Details

See Senate Version of this Bill:
S4783
Law Section:
Public Health Law
Laws Affected:
Amd §4900, Pub Health L; amd §4900, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A723
2011-2012: A662
2013-2014: A2693, S6281
2017-2018: A2539
2019-2020: A3076
2021-2022: A879

A445 - Summary

Relates to the definition of a clinical peer reviewer by clarifying that such term shall be applicable for the entire utilization review and external appeal article and means either a physician or a health care professional with certain qualifications.

A445 - Bill Text download pdf

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

                                   445

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  M.  of A. GOTTFRIED, DINOWITZ, GALEF, PAULIN, ROSENTHAL,
  SCHIMEL, KAVANAGH, COLTON, JAFFEE -- read once  and  referred  to  the
  Committee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to the definition of clinical peer reviewer

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

  Section 1. Subdivision 2 of section 4900 of the public health law,  as
amended  by  chapter  586  of the laws of 1998, item (B) of subparagraph
(ii) of paragraph (a) as amended and subparagraph (iii) of paragraph (a)
as added by chapter 41 of the laws  of  2014,  is  amended  to  read  as
follows:
  2. "Clinical peer reviewer" means:
  (a) [for purposes of title one of this article:
  (i)  a  physician  who  possesses  a  current and valid non-restricted
license to practice medicine; or
  (ii) a health care professional other than a licensed physician who:
  (A) where applicable, possesses a  current  and  valid  non-restricted
license,  certificate  or  registration  or,  where  no  provision for a
license, certificate or registration  exists,  is  credentialed  by  the
national accrediting body appropriate to the profession; and
  (B)  is  in  the  same profession and same or similar specialty as the
health care provider who typically  manages  the  medical  condition  or
disease  or  provides the health care service or treatment under review;
or
  (iii) for purposes of a determination involving substance use disorder
treatment:
  (A) a physician who  possesses  a  current  and  valid  non-restricted
license  to  practice  medicine and who specializes in behavioral health

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04173-01-5

Co-Sponsors

view additional co-sponsors

A445A (ACTIVE) - Details

See Senate Version of this Bill:
S4783
Law Section:
Public Health Law
Laws Affected:
Amd §4900, Pub Health L; amd §4900, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A723
2011-2012: A662
2013-2014: A2693, S6281
2017-2018: A2539
2019-2020: A3076
2021-2022: A879

A445A (ACTIVE) - Summary

Relates to the definition of a clinical peer reviewer by clarifying that such term shall be applicable for the entire utilization review and external appeal article and means either a physician or a health care professional with certain qualifications.

A445A (ACTIVE) - Bill Text download pdf

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

                                 445--A
                                                          Cal. No. 5

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  M.  of A. GOTTFRIED, DINOWITZ, GALEF, PAULIN, ROSENTHAL,
  SCHIMEL, KAVANAGH, COLTON, JAFFEE, ABINANTI -- read once and  referred
  to the Committee on Health -- advanced to a third reading, amended and
  ordered reprinted, retaining its place on the order of third reading

AN ACT to amend the public health law and the insurance law, in relation
  to the definition of clinical peer reviewer

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

  Section 1. Subdivision 2 of section 4900 of the public health law,  as
amended  by  chapter  586  of the laws of 1998, item (B) of subparagraph
(ii) of paragraph (a) as amended and subparagraph (iii) of paragraph (a)
as added by chapter 41 of the laws  of  2014,  is  amended  to  read  as
follows:
  2. "Clinical peer reviewer" means:
  (a) [for purposes of title one of this article:
  (i)  a  physician  who  possesses  a  current and valid non-restricted
license to practice medicine; or
  (ii) a health care professional other than a licensed physician who:
  (A) where applicable, possesses a  current  and  valid  non-restricted
license,  certificate  or  registration  or,  where  no  provision for a
license, certificate or registration  exists,  is  credentialed  by  the
national accrediting body appropriate to the profession; and
  (B)  is  in  the  same profession and same or similar specialty as the
health care provider who typically  manages  the  medical  condition  or
disease  or  provides the health care service or treatment under review;
or
  (iii) for purposes of a determination involving substance use disorder
treatment:
  (A) a physician who  possesses  a  current  and  valid  non-restricted
license  to  practice  medicine and who specializes in behavioral health

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets