Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jul 22, 2020 |
referred to insurance delivered to assembly passed senate |
Jul 21, 2020 |
ordered to third reading cal.811 |
Jul 20, 2020 |
reported and committed to rules |
Jan 09, 2020 |
referred to insurance |
Senate Bill S7159
2019-2020 Legislative Session
Sponsored By
(D, WF) 31st Senate District
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
Votes
co-Sponsors
(D) Senate District
(D) Senate District
(D, WF) 13th Senate District
(D, WF) 18th Senate District
2019-S7159 (ACTIVE) - Details
2019-S7159 (ACTIVE) - Sponsor Memo
BILL NUMBER: S7159 SPONSOR: JACKSON TITLE OF BILL: 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 PURPOSE: The purpose of this legislation is to provide individuals with accurate medical insurance coverage notices. Medical insurance companies send individuals letters that conspicuously state that their medical coverage for a procedure or therapy has been denied; however, when looking closer at the notice, the coverage is actually partially approved. This legis- lation aims to end this deceptive practice and to require medical insur- ance companies to provide coverage letters with accurate coverage infor- mation. SUMMARY OF PROVISIONS:
2019-S7159 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7159 I N S E N A T E January 9, 2020 ___________ Introduced by Sens. JACKSON, BENJAMIN, CARLUCCI, RAMOS, SALAZAR -- 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 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
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