Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
May 13, 2022 |
referred to insurance |
Assembly Bill A10303
2021-2022 Legislative Session
Sponsored By
GUNTHER
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
2021-A10303 (ACTIVE) - Details
- Current Committee:
- Assembly Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd §3224-b, Ins L; amd §4406-c, Pub Health L
- Versions Introduced in 2023-2024 Legislative Session:
-
A5069
2021-A10303 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 10303 I N A S S E M B L Y May 13, 2022 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Gunther) -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the public health law, in relation to the processing of health claims THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 2 of subsection (a) of section 3224-b of the insurance law, as added by chapter 551 of the laws of 2006, is amended to read as follows: (2) Subject to the provisions of paragraph three of this subsection, a health plan shall accept and initiate the processing of all health care claims submitted by a physician, INCLUDING BUT NOT LIMITED TO EVALUATION AND MANAGEMENT CODES, pursuant to and consistent with the current version of the American medical association's current procedural termi- nology (CPT) codes, reporting guidelines and conventions and the centers for medicare and medicaid services healthcare common procedure coding system (HCPCS). § 2. Paragraphs 4 and 5 of subsection (b) of section 3224-b of the insurance law, as amended by chapter 237 of the laws of 2009, are renum- bered paragraphs 5 and 6 and a new paragraph 4 is added to read as follows: (4) NOTWITHSTANDING PARAGRAPH THREE OF THIS SUBSECTION, WITH RESPECT TO CLAIMS FOR EVALUATION AND MANAGEMENT CODES AS SUCH ARE DEFINED AND SET FORTH IN THE CURRENT EDITION OF AMERICAN MEDICAL ASSOCIATION'S CURRENT PROCEDURAL TERMINOLOGY (CPT), A HEALTH PLAN SHALL FOLLOW, COMPLY WITH AND IMPLEMENT FOR PURPOSES OF CLAIMS PROCESSING, CLAIMS PAYMENT AND CLAIMS REVIEW, SUCH CURRENT PROCEDURAL TERMINOLOGY PROVISIONS, GUIDE- LINES AND CONVENTIONS FOR BOTH THE SELECTION AND THE DOCUMENTATION OF EVALUATION AND MANAGEMENT SERVICES. § 3. Section 4406-c of the public health law is amended by adding two new subdivisions 13 and 14 to read as follows: 13. A HEALTH MAINTENANCE ORGANIZATION LICENSED PURSUANT TO ARTICLE FORTY-THREE OF THE INSURANCE LAW OR CERTIFIED PURSUANT TO THIS ARTICLE OR AN INDEPENDENT PRACTICE ASSOCIATION CERTIFIED OR RECOGNIZED PURSUANT EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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