Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Dec 12, 2019 |
signed chap.640 |
Dec 06, 2019 |
delivered to governor |
Jun 19, 2019 |
returned to senate passed assembly ordered to third reading cal.493 substituted for a2880b |
Jun 19, 2019 |
substituted by s5328a |
Jun 14, 2019 |
amended on third reading 2880b |
Jun 11, 2019 |
amended on third reading (t) 2880a |
Jun 11, 2019 |
vote reconsidered - restored to third reading returned to assembly recalled from senate |
Jun 04, 2019 |
referred to rules delivered to senate passed assembly |
May 30, 2019 |
advanced to third reading cal.493 reported |
May 21, 2019 |
reported referred to codes |
Jan 28, 2019 |
referred to insurance |
Assembly Bill A2880
Signed By Governor2019-2020 Legislative Session
Sponsored By
HUNTER
Archive: Last Bill Status Via S5328 - Signed by Governor
- 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
Bill Amendments
2019-A2880 - Details
2019-A2880 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 2880 2019-2020 Regular Sessions I N A S S E M B L Y January 28, 2019 ___________ 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. LBD04761-01-9
2019-A2880A - Details
2019-A2880A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 2880--A Cal. No. 493 2019-2020 Regular Sessions I N A S S E M B L Y January 28, 2019 ___________ Introduced by M. of A. HUNTER -- read once and referred to the Committee on Insurance -- reported and referred to the Committee on Codes -- advanced to a third reading, passed by Assembly and delivered to the Senate, recalled from the Senate, vote reconsidered, bill amended, ordered reprinted, retaining its place on the order of third reading AN ACT to amend the insurance law, in relation to denial of coverage of additional or alternative services or procedures related to health care services for which pre-authorization was granted or did not require pre-authorization; and to repeal certain provisions of such law relating thereto THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (c) of section 3238 of the insurance law is REPEALED and a new subsection (c) is added to read as follows: (C)(1) IF A HEALTH CARE PROVIDER, WHILE PROVIDING A SERVICE OR PROCE- DURE TO TREAT A PATIENT, DETERMINES THAT AN ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE IS NECESSARY AS PART OF SUCH TREATMENT, AND IN THE SOLE JUDGMENT OF THE HEALTH CARE PROVIDER IT IS NOT ADVISABLE TO INTER- RUPT THE PROVISION OF CARE TO THE PATIENT IN ORDER TO OBTAIN PRE-AUTHOR- IZATION FROM A HEALTH PLAN FOR THE ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE, A DENIAL OF PAYMENT FOR THE ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE DUE TO LACK OF PRE-AUTHORIZATION SHALL BE UPHELD ON APPEAL ONLY IF IT IS DETERMINED THAT: (I) THE ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE IS NOT A COVERED BENEFIT; (II) THE ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE 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; (III) THE ADDITIONAL OR ALTERNATIVE SERVICE OR PROCEDURE WAS EXPER- IMENTAL OR INVESTIGATIONAL PURSUANT TO SECTION FOUR THOUSAND NINE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
2019-A2880B (ACTIVE) - Details
2019-A2880B (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 2880--B Cal. No. 493 2019-2020 Regular Sessions I N A S S E M B L Y January 28, 2019 ___________ Introduced by M. of A. HUNTER -- read once and referred to the Committee on Insurance -- reported and referred to the Committee on Codes -- advanced to a third reading, passed by Assembly and delivered to the Senate, recalled from the Senate, vote reconsidered, bill amended, ordered reprinted, retaining its place on the order of third reading -- again amended on third reading, ordered reprinted, retaining its place on the order of third reading AN ACT to amend the insurance law, in relation to denial of coverage of additional or related services or procedures related to health care services for which pre-authorization was granted or did not require pre-authorization; and to repeal certain provisions of such law relat- ing thereto THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (c) of section 3238 of the insurance law is REPEALED and a new subsection (c) is added to read as follows: (C)(1) IF A HEALTH CARE PROVIDER, WHILE PROVIDING A SERVICE OR PROCE- DURE TO TREAT A PATIENT, DETERMINES THAT PROVIDING AN ADDITIONAL OR RELATED SERVICE OR PROCEDURE, SUCH AS A SERVICE OR PROCEDURE TO ADDRESS A CO-MORBID CONDITION, IS IMMEDIATELY NECESSARY AS PART OF SUCH TREAT- MENT, AND IN THE CLINICAL JUDGMENT OF THE HEALTH CARE PROVIDER IT IS A MEDICALLY TIMELY SERVICE AND IT WOULD NOT BE MEDICALLY ADVISABLE TO INTERRUPT THE PROVISION OF CARE TO THE PATIENT IN ORDER TO OBTAIN PRE- AUTHORIZATION FROM A HEALTH PLAN FOR THE ADDITIONAL OR RELATED SERVICE OR PROCEDURE, A DENIAL OF PAYMENT FOR THE ADDITIONAL OR RELATED SERVICE OR PROCEDURE DUE TO LACK OF PRE-AUTHORIZATION SHALL BE UPHELD ON APPEAL ONLY IF IT IS DETERMINED THAT: (I) THE ADDITIONAL OR RELATED SERVICE OR PROCEDURE IS NOT A COVERED BENEFIT; EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04761-07-9
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