Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jan 17, 2020 |
referred to insurance |
Assembly Bill A9085
2019-2020 Legislative Session
Sponsored By
GOTTFRIED R
Archive: Last Bill Status - In Assembly Committee
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
2019-A9085 (ACTIVE) - Details
2019-A9085 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 9085 I N A S S E M B L Y January 17, 2020 ___________ Introduced by M. of A. GOTTFRIED -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring specifica- tion between partial approval of medical claims and a denial of medical claims on written notices to an insurer THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (b) of section 3224-a of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (b) In a case where the obligation of an insurer or an organization or corporation licensed or certified pursuant to article forty-three or forty-seven of this chapter or article forty-four of the public health law to pay a claim or make a payment for health care services rendered is not reasonably clear due to a good faith dispute regarding the eligi- bility of a person for coverage, the liability of another insurer or corporation or organization for all or part of the claim, the amount of the claim, the benefits covered under a contract or agreement, or the manner in which services were accessed or provided, an insurer or organ- ization or corporation shall pay any undisputed portion of the claim in accordance with this subsection and notify the policyholder, covered person or health care provider in writing within thirty calendar days of the receipt of the claim: (1) WHETHER THE CLAIM OR BILL HAS BEEN DENIED OR PARTIALLY APPROVED; (2) WHICH CLAIM OR MEDICAL PAYMENT that it is not obligated to pay [the claim or make the medical payment,] stating the specific reasons why it is not liable; [or (2)] AND (3) to request all additional information needed to determine liabil- ity to pay the claim or make the health care payment. Upon receipt of the information requested in paragraph [two] THREE of this subsection or an appeal of a claim or bill for health care services denied pursuant to [paragraph one of] this subsection, an insurer or organization or corporation licensed or certified pursuant to article EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
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