Assembly Bill A879

2021-2022 Legislative Session

Relates to the definition of a clinical peer reviewer

download bill text pdf

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Archive: Last Bill Status - Passed Senate & Assembly


  • 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

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2021-A879 (ACTIVE) - Details

See Senate Version of this Bill:
S8113
Law Section:
Public Health Law
Laws Affected:
Amd §4900, Pub Health L; amd §4900, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A723
2011-2012: A662
2013-2014: A2693
2015-2016: A445
2017-2018: A2539
2019-2020: A3076, S8844

2021-A879 (ACTIVE) - Summary

Relates to the definition of a clinical peer reviewer by clarifying that such term shall be applicable for the entire utilization review and external appeal article and means either a physician or a health care professional with certain qualifications.

2021-A879 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    879
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced by M. of A. GOTTFRIED, DINOWITZ, GALEF, PAULIN, L. ROSENTHAL,
   COLTON, ABINANTI -- read once and referred to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to the definition of clinical peer reviewer

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 2 of section 4900 of the public health law,  as
 amended  by  chapter  586  of the laws of 1998, item (B) of subparagraph
 (ii) of paragraph (a) as amended by chapter 41 of the laws of  2014  and
 subparagraph  (iii) as amended and subparagraph (iv) of paragraph (a) as
 added by section 42 of subpart A of part BB of chapter 57 of the laws of
 2019, is amended to read as follows:
   2. "Clinical peer reviewer" means:
   (a) [for purposes of title one of this article:
   (i) a physician who  possesses  a  current  and  valid  non-restricted
 license to practice medicine; or
   (ii) a health care professional other than a licensed physician who:
   (A)  where  applicable,  possesses  a current and valid non-restricted
 license, certificate or  registration  or,  where  no  provision  for  a
 license,  certificate  or  registration  exists,  is credentialed by the
 national accrediting body appropriate to the profession; and
   (B) is in the same profession and same or  similar  specialty  as  the
 health  care  provider  who  typically  manages the medical condition or
 disease or provides the health care service or treatment  under  review;
 or
   (iii) for purposes of a determination involving substance use disorder
 treatment:
   (A)  a  physician  who  possesses  a  current and valid non-restricted
 license to practice medicine and who specializes  in  behavioral  health

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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