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Senate Bill S4070

2015-2016 Legislative Session

Authorizes a pilot program for enhanced prior approval of high cost diagnostic radiology services

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Archive: Last Bill Status - In Senate Committee Health Committee

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2015-S4070 (ACTIVE) - Details

Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Add ยง369-hh, Soc Serv L
Versions Introduced in Other Legislative Sessions:
2009-2010: S5764
2011-2012: S1550
2013-2014: S132

2015-S4070 (ACTIVE) - Summary

Authorizes the commissioner of health, within fiscal year 2015-2016, to contract with high bidders to perform pilot projects to assess the feasibility of reducing medically unnecessary high cost radiological procedures and generalizing cost savings to the state through enhanced medical management and prior review of orders for diagnostic imaging.

2015-S4070 (ACTIVE) - Sponsor Memo

2015-S4070 (ACTIVE) - Bill Text download pdf 

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

                                  4070

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            February 26, 2015
                               ___________

Introduced  by  Sen. SAMPSON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the social services law, in relation  to  authorizing  a
  pilot  program  for  enhanced  prior  approval of high cost diagnostic
  radiology services

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

  Section  1. The social services law is amended by adding a new section
369-hh to read as follows:
  S 369-HH. PILOT PROGRAM FOR ENHANCED PRIOR APPROVAL OF HIGH COST DIAG-
NOSTIC  RADIOLOGY  SERVICES.  1.  PURSUANT  TO   SECTION   ONE   HUNDRED
SIXTY-THREE  OF THE STATE FINANCE LAW, THE COMMISSIONER OF HEALTH SHALL,
WITHIN THE FISCAL YEAR OF TWO THOUSAND  FIFTEEN--TWO  THOUSAND  SIXTEEN,
CONTRACT  WITH QUALIFIED BIDDERS TO PERFORM PILOT PROJECTS TO ASSESS THE
FEASIBILITY OF REDUCING MEDICALLY  UNNECESSARY  HIGH  COST  RADIOLOGICAL
PROCEDURES  AND  GENERALIZING COST SAVINGS TO THE STATE THROUGH ENHANCED
MEDICAL MANAGEMENT AND PRIOR REVIEW OF ORDERS FOR DIAGNOSTIC IMAGING.
  2. THE COMMISSIONER OF HEALTH SHALL SELECT AN ENTITY TO  PERFORM  SUCH
PILOT PROJECT UTILIZING THE FOLLOWING SELECTION CRITERIA:
  (A) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
CURRENTLY   UTILIZING   LICENSED  PROFESSIONALS  TO  CONDUCT  INTAKE  OF
PATIENTS;
  (B) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
CURRENTLY UTILIZING ONLY LICENSED  RADIOLOGISTS  TO  MAKE  PRIOR  REVIEW
DETERMINATIONS;
  (C) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
CURRENTLY UTILIZING LICENSED RADIOLOGISTS TO REQUEST ADDITIONAL INFORMA-
TION, AS NECESSARY, FROM THE TREATING PROVIDER;
  (D)  THE  ENTITY SHALL BE BASED IN NEW YORK AND AT LEAST FIFTY PERCENT
OF THE ENTITY'S EMPLOYEES SHALL RESIDE IN NEW YORK.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09105-01-5

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