Bill Text: NY A00448 | 2015-2016 | General Assembly | Amended

---

Bill Title: Requires managed care programs to establish procedures to assure participant access to medical assistance dental services to which they are otherwise entitled, other than through the managed care provider.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Introduced - Dead) 2016-03-04 - print number 448a [A00448 Detail]

Download: New_York-2015-A00448-Amended.html

---

                STATE OF NEW YORK
        ________________________________________________________________________
                                         448--A
                               2015-2016 Regular Sessions
                   IN ASSEMBLY
                                       (Prefiled)
                                     January 7, 2015
                                       ___________
        Introduced  by  M.  of A. GOTTFRIED, GLICK, ORTIZ, PAULIN -- Multi-Spon-
          sored by -- M. of A. BRENNAN, COLTON, COOK, CYMBROWITZ, GANTT, HOOPER,
          JAFFEE, LIFTON, MAGNARELLI, PERRY -- read once  and  referred  to  the
          Committee  on  Health  --  recommitted  to  the Committee on Health in
          accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee
        AN ACT to amend the social services law,  in  relation  to  requiring  a
          managed  care  program  to  establish procedures through which partic-
          ipants will be assured access to medical assistance dental services to
          which they are otherwise entitled, other than through the managed care
          provider
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Subparagraph  (iii)  of paragraph (a) of subdivision 4 of
     2  section 364-j of the social services law, as amended by  section  14  of
     3  part C of chapter 58 of the laws of 2004, clause (E) as added and clause
     4  (F)  as  relettered  by  chapter 37 of the laws of 2010, clause (E-1) as
     5  added by chapter 449 of the laws of 2013, is amended to read as follows:
     6    (iii) under a managed care program, not  all  managed  care  providers
     7  must be required to provide the same set of medical assistance services.
     8  The  managed  care  program  shall  establish  procedures  through which
     9  participants will be assured access to all medical  assistance  services
    10  to  which  they  are  otherwise entitled, other than through the managed
    11  care provider, where:
    12    (A) the service is not reasonably  available  directly  or  indirectly
    13  from the managed care provider,
    14    (B) it is necessary because of emergency or geographic unavailability,
    15  or
    16    (C) the services provided are family planning services; or
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02695-03-6