senate Bill S4922A

Signed By Governor
2015-2016 Legislative Session

Provides for the expedited utilization review of court ordered mental health and/or substance use disorder services

download bill text pdf

Sponsored By

Archive: Last Bill Status Via A1327 - Signed by Governor


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

Your Voice

do you support this bill?

Please enter your contact information

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.

Actions

view actions (11)
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 18, 2015 substituted by a1327a
Jun 11, 2015 amended on third reading (t) 4922a
Jun 02, 2015 advanced to third reading
Jun 01, 2015 2nd report cal.
May 28, 2015 1st report cal.1062
Apr 23, 2015 referred to health

Co-Sponsors

S4922 - Details

See Assembly Version of this Bill:
A1327
Law Section:
Public Health Law
Laws Affected:
Amd §§4903 & 4904, Pub Health L; amd §§4903 & 4904, Ins L
Versions Introduced in 2013-2014 Legislative Session:
A10100

S4922 - Summary

Provides for the expedited utilization review of court ordered mental health and/or substance use disorder services.

S4922 - Sponsor Memo

S4922 - Bill Text download pdf

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

                                  4922

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             April 23, 2015
                               ___________

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

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

S4922A (ACTIVE) - Details

See Assembly Version of this Bill:
A1327
Law Section:
Public Health Law
Laws Affected:
Amd §§4903 & 4904, Pub Health L; amd §§4903 & 4904, Ins L
Versions Introduced in 2013-2014 Legislative Session:
A10100

S4922A (ACTIVE) - Summary

Provides for the expedited utilization review of court ordered mental health and/or substance use disorder services.

S4922A (ACTIVE) - Sponsor Memo

S4922A (ACTIVE) - Bill Text download pdf

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

                                 4922--A
    Cal. No. 1062

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             April 23, 2015
                               ___________

Introduced  by  Sens.  HANNON, LARKIN, VALESKY -- read twice and ordered
  printed, and when printed to be committed to the Committee  on  Health
  -- reported favorably from said committee, ordered to first and second
  report,  ordered  to  a  third reading, amended and ordered reprinted,
  retaining its place in the 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.
                                                           LBD06406-04-5

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.