Bill Text: NY A00564 | 2017-2018 | General Assembly | Introduced

---

Bill Title: Relates to payment of claims submitted by healthcare agencies.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2018-01-03 - referred to ways and means [A00564 Detail]

Download: New_York-2017-A00564-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________
                                           564
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                     January 9, 2017
                                       ___________
        Introduced  by  M.  of  A.  ABINANTI,  SKOUFIS,  MOSLEY, CURRAN, RAIA --
          Multi-Sponsored by -- M. of A. McDONOUGH, RA -- read once and referred
          to the Committee on Health
        AN ACT to amend the public health law, in relation to payment of  claims
          submitted by healthcare agencies
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1.  Section 3621 of the public health law, as added by section
     2  57-a of part A of chapter 56 of the laws of 2013, is amended to read  as
     3  follows:
     4    § 3621. Payment of claims. 1. Notwithstanding any law to the contrary,
     5  the provisions of section thirty-two hundred twenty-four-a of the insur-
     6  ance  law, and regulations thereunder, shall apply to claims for payment
     7  submitted by a licensed home care services agency, certified home health
     8  agency, long term home health care program, or fiscal intermediary oper-
     9  ating under section three hundred sixty-five-f of  the  social  services
    10  law,  pursuant  to  a  contract  with  a  payor under section forty-four
    11  hundred three-f of this chapter or section three hundred sixty-four-j of
    12  the social services law, and such claims shall be subject to and settled
    13  in compliance with the standards set forth in such section.
    14    2. For the purposes of this section, a "clean claim" shall:
    15    (a) identify the licensed home care services program,  certified  home
    16  health agency, long term home health care program or fiscal intermediary
    17  operating  pursuant  to section three hundred sixty-five-f of the social
    18  services law;
    19    (b) sufficiently identify the eligible covered person;
    20    (c) list the date and place of service;
    21    (d) substantiate the appropriateness of the service provided;
    22    (e) state if prior authorization is required for such eligible covered
    23  person and service; and
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03331-01-7
        A. 564                              2
     1    (f) state any documentation  as  reasonably  required  by  any  entity
     2  referenced in this section.
     3    3.  Each clean claim or payment for services processed in violation of
     4  this section shall constitute a separate violation. In addition  to  the
     5  penalties provided in this chapter, any organization or corporation that
     6  fails  to  adhere  to  the  standards contained in this section shall be
     7  obligated to pay to certified  home  health  agencies,  long  term  home
     8  health  care  programs,  licensed  home  health  care programs or fiscal
     9  intermediaries operating pursuant to section three hundred  sixty-five-f
    10  of  the  social  services  law  in full settlement of the bill, claim or
    11  payment plus interest on the amount of such bill, claim  or  payment  of
    12  the  greater  of  the  rate equal to the rate set by the commissioner of
    13  taxation and finance for corporate taxes pursuant to  paragraph  one  of
    14  subsection  (e)  of  section  one  thousand ninety-six of the tax law or
    15  twelve percent per annum, to be computed from the date the  bill,  claim
    16  or payment was required to be made.
    17    § 2. This act shall take effect immediately.