|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Feb 11, 2019||recommit, enacting clause stricken|
|Jan 14, 2019||referred to insurance|
senate Bill S1394
Archive: Last Bill Status - Stricken
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S1394 (ACTIVE) - Details
S1394 (ACTIVE) - Sponsor Memo
BILL NUMBER: S1394 SPONSOR: RIVERA TITLE OF BILL: 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 PURPOSE: To expand the current prior authorization exception for surgical and invasive procedures to include concurrent symptoms and side effects. SUMMARY OF PROVISIONS: Section 1 of the bill adds a new subsection (c-1) of section 3238 of the Insurance Law to include concurrent symptoms and side effects to the types of conditions that cannot be denied for lack of prior authori- zation.
S1394 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 1394 2019-2020 Regular Sessions I N S E N A T E January 14, 2019 ___________ Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed 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. LBD04761-01-9
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