| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Jan 03, 2018 |
referred to health |
| Jun 16, 2017 |
print number 5340a |
| Jun 16, 2017 |
amend and recommit to health |
| Mar 22, 2017 |
referred to health |
Senate Bill S5340A
2017-2018 Legislative Session
Sponsored By
(R, C, IP) Senate District
Archive: Last Bill Status - In Senate Committee Health Committee
Actions
Bill Amendments
2017-S5340 - Details
- See Assembly Version of this Bill:
- A7862
- Current Committee:
- Senate Health
- Law Section:
- Social Services Law
- Laws Affected:
- Amd §364-j, Soc Serv L
- Versions Introduced in 2019-2020 Legislative Session:
-
S1804, A3068
2017-S5340 - Sponsor Memo
BILL NUMBER: S5340
TITLE OF BILL : An act to amend the social services law, in relation
to penalties to managed care organizations
PURPOSE OF THE BILL :
This bill would authorize the Office of the Medicaid Inspector General
(OMIG) to impose penalties against managed care organizations (MCO)
for fraudulent or abusive submissions of encounter data to the State.
SUMMARY OF PROVISIONS :
Section 1 would amend Social Services L. § 364-j(32)(d) to create an
exception to the prohibition on assessing penalties for late,
incomplete or inaccurate encounter data, for cases of fraud and abuse.
Section 2 would provide the effective date.
STATEMENT IN SUPPORT :
The manipulation of encounter data can result in significant Medicaid
overpayments within New York's managed care system. A pattern of
inaccurate encounter data submissions will disrupt risk adjusted
capitation premium methodologies and cause significant harm to the
integrity of the Medicaid program. As more of the Medicaid managed
2017-S5340 - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
5340
2017-2018 Regular Sessions
I N S E N A T E
March 22, 2017
___________
Introduced by Sen. HANNON -- (at request of the Medicaid Inspector
General) -- 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 penalties to
managed care organizations
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (d) of subdivision 32 of section 364-j of the
social services law, as added by section 15 of part B of chapter 59 of
the laws of 2016, is amended to read as follows:
(d) Penalties under this subdivision may be applied to any and all
circumstances described in paragraph (b) of this subdivision until the
managed care organization complies with the requirements for submission
of encounter data. No penalties for late, incomplete or inaccurate
encounter data shall be assessed against managed care organizations in
addition to those provided for in this subdivision, EXCEPT IN CASES OF
FRAUD OR ABUSE.
§ 2. This act shall take effect on the ninetieth day after it shall
have become a law, provided that the amendments to section 364-j of the
social services law, made by section one of this act, shall not affect
the repeal of such section, and shall be deemed repealed therewith.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10145-01-7
2017-S5340A (ACTIVE) - Details
- See Assembly Version of this Bill:
- A7862
- Current Committee:
- Senate Health
- Law Section:
- Social Services Law
- Laws Affected:
- Amd §364-j, Soc Serv L
- Versions Introduced in 2019-2020 Legislative Session:
-
S1804, A3068
2017-S5340A (ACTIVE) - Sponsor Memo
BILL NUMBER: S5340A
TITLE OF BILL : An act to amend the social services law, in relation
to penalties to managed care organizations
PURPOSE :
This bill would authorize the Office of the Medicaid Inspector General
(OMIG) to impose penalties currently authorized by law against managed
care organizations (MCO) for fraudulent or abusive submissions of
encounter data to the State.
SUMMARY OF PROVISIONS :
Section 1 would amend Social Services L. § 364-j(32)(d) to create an
exception to the prohibition on assessing penalties currently
authorized by law for late, incomplete or inaccurate encounter data,
for cases of fraud and abuse.
Section 2 would provide the effective date.
JUSTIFICATION :
The manipulation of encounter data can result in significant Medicaid
overpayments within New York's managed care system. A pattern of
inaccurate encounter data submissions will disrupt risk adjusted
2017-S5340A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
5340--A
2017-2018 Regular Sessions
I N S E N A T E
March 22, 2017
___________
Introduced by Sen. HANNON -- read twice and ordered printed, and when
printed to be committed to the Committee on Health -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the social services law, in relation to penalties to
managed care organizations
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (d) of subdivision 32 of section 364-j of the
social services law, as added by section 15 of part B of chapter 59 of
the laws of 2016, is amended to read as follows:
(d) (I) Penalties under this subdivision may be applied to any and all
circumstances described in paragraph (b) of this subdivision until the
managed care organization complies with the requirements for submission
of encounter data.
(II) No penalties for late, incomplete or inaccurate encounter data
shall be assessed against managed care organizations in addition to
those provided for in this subdivision, PROVIDED, HOWEVER, THAT NOTHING
IN THIS PARAGRAPH SHALL PROHIBIT THE IMPOSITION OF PENALTIES, IN CASES
OF FRAUD OR ABUSE, OTHERWISE AUTHORIZED BY LAW.
§ 2. This act shall take effect on the ninetieth day after it shall
have become a law, provided that the amendments to section 364-j of the
social services law, made by section one of this act, shall not affect
the repeal of such section, and shall be deemed repealed therewith.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10145-03-7
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.
Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.