assembly Bill A1129

2017-2018 Legislative Session

Limits denial of coverage of additional treatment related to health care services for which pre-authorization is required and was granted

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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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Actions

view actions (12)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 22, 2018 referred to insurance
delivered to senate
passed assembly
Jan 03, 2018 ordered to third reading cal.77
returned to assembly
died in senate
Jan 23, 2017 referred to insurance
delivered to senate
passed assembly
Jan 19, 2017 advanced to third reading cal.7
Jan 17, 2017 reported
Jan 10, 2017 referred to insurance

A1129 (ACTIVE) - Details

See Senate Version of this Bill:
S3568
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §3238, Ins L
Versions Introduced in Other Legislative Sessions:
2015-2016: A10268, S7558
2019-2020: A2880, S1394, S5328

A1129 (ACTIVE) - Summary

Limits denial of coverage of additional treatment related to health care services for which pre-authorization is required and was granted.

A1129 (ACTIVE) - Bill Text download pdf


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

                                  1129

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 10, 2017
                               ___________

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 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.
  § 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.
                                                           LBD02613-01-7