Bill Text: NY A07976 | 2021-2022 | General Assembly | Amended
Bill Title: Enacts the "access to comprehensive cancer enhanced services strategy (ACCESS) demonstration project" to assure more equitable access to specialized cancer care; makes related provisions.
Spectrum: Moderate Partisan Bill (Democrat 13-2)
Status: (Introduced - Dead) 2022-03-28 - ordered to third reading rules cal.64 [A07976 Detail]
Download: New_York-2021-A07976-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 7976--A 2021-2022 Regular Sessions IN ASSEMBLY June 4, 2021 ___________ Introduced by M. of A. SEAWRIGHT -- read once and referred to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law and the social services law, in relation to assuring more equitable access to specialized cancer care; and providing for the repeal of such provisions upon expiration there- of The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act shall be known and may be cited as the "access to 2 comprehensive cancer enhanced services strategy (ACCESS) demonstration 3 project." 4 § 2. Subparagraph (vi) of paragraph (b) of subdivision 1 of section 5 268-d of the public health law, as added by section 2 of part T of chap- 6 ter 57 of the laws of 2019, is amended to read as follows: 7 (vi) contracts with any national cancer institute-designated cancer 8 center licensed by the department within the health plan's service area 9 that is willing to provide cancer-related inpatient, outpatient and 10 medical services to enrollees in all health plans offering Marketplace 11 coverage in such cancer center's service area under the prevailing 12 terms and conditions that the plan requires of other similar providers 13 to be included in the plan's provider network, provided that such terms 14 shall include reimbursement of such center at no less than and in 15 accordance with the fee-for-service Medicaid payment rate and methodol- 16 ogy applicable to the center's inpatient and outpatient services; and 17 (vii) complies with the insurance law and this chapter requirements 18 applicable to health insurance issued in this state and any regulations 19 promulgated pursuant thereto that do not conflict with or prevent the 20 application of federal requirements; and 21 § 3. Subdivision 4 of section 364-j of the social services law is 22 amended by adding a new paragraph (w) to read as follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11279-03-1A. 7976--A 2 1 (w) A managed care provider shall provide or arrange, directly or 2 indirectly (including by referral), for access to and coverage of 3 services provided by any national cancer institute-designated cancer 4 center licensed by the department of health within the managed care 5 provider's service area that is willing to agree to provide cancer-re- 6 lated inpatient, outpatient and medical services to participants in all 7 managed care providers offering coverage to medical assistance recipi- 8 ents in such cancer center's service area under the prevailing terms and 9 conditions that the managed care provider requires of other similar 10 providers to be included in the managed care provider's network, 11 provided that such terms shall include reimbursement of such center at 12 no less than and in accordance with the fee-for-service Medicaid payment 13 rate and methodology applicable to the center's inpatient and outpatient 14 services. 15 § 4. Paragraph (c) of subdivision 1 of section 369-gg of the social 16 services law, as amended by section 2 of part H of chapter 57 of the 17 laws of 2021, is amended to read as follows: 18 (c) "Health care services" means (i) the services and supplies as 19 defined by the commissioner in consultation with the superintendent of 20 financial services, and shall be consistent with and subject to the 21 essential health benefits as defined by the commissioner in accordance 22 with the provisions of the patient protection and affordable care act 23 (P.L. 111-148) and consistent with the benefits provided by the refer- 24 ence plan selected by the commissioner for the purposes of defining such 25 benefits, and shall include coverage of and access to the services of 26 any national cancer institute-designated cancer center licensed by the 27 department of health within the service area of the approved organiza- 28 tion that is willing to agree to provide cancer-related inpatient, 29 outpatient and medical services to all enrollees in approved organiza- 30 tions' plans in such cancer center's service area under the prevailing 31 terms and conditions that the approved organization requires of other 32 similar providers to be included in the approved organization's network, 33 provided that such terms shall include reimbursement of such center at 34 no less than and in accordance with the fee-for-service payment rate and 35 methodology applicable to basic health insurance plan payments for inpa- 36 tient and outpatient services; and (ii) dental and vision services as 37 defined by the commissioner. 38 § 5. This act shall take effect on the first of January next succeed- 39 ing the date on which it shall have become a law and shall apply to all 40 coverage or policies issued or renewed on or after such effective date 41 and shall expire and be deemed repealed five years after such date; 42 provided, however, that the amendments to subdivision 4 of section 364-j 43 of the social services law made by section three of this act shall not 44 affect the repeal of such section and shall be deemed repealed there- 45 with; provided, further, that the amendments to paragraph (c) of subdi- 46 vision 1 of section 369-gg of the social services law made by section 47 four of this act shall not affect the expiration of such paragraph and 48 shall be deemed to expire therewith.
