Bill Text: NY A03080 | 2011-2012 | General Assembly | Introduced

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Bill Title: Authorizes the commissioner of health, within fiscal year 2011-2012, to contract with high bidders to perform pilot projects to assess the feasibility of reducing medically unnecessary high cost radiological procedures and generalizing cost savings to the state through enhanced medical management and prior review of orders for diagnostic imaging.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2012-01-04 - referred to health [A03080 Detail]

Download: New_York-2011-A03080-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         3080
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                   January 24, 2011
                                      ___________
       Introduced by M. of A. LENTOL -- read once and referred to the Committee
         on Health
       AN  ACT  to  amend the social services law, in relation to authorizing a
         pilot program for enhanced prior  approval  of  high  cost  diagnostic
         radiology services
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. The social services law is amended by adding a new  section
    2  369-gg to read as follows:
    3    S 369-GG. PILOT PROGRAM FOR ENHANCED PRIOR APPROVAL OF HIGH COST DIAG-
    4  NOSTIC   RADIOLOGY   SERVICES.   1.  PURSUANT  TO  SECTION  ONE  HUNDRED
    5  SIXTY-THREE OF THE STATE FINANCE LAW, THE COMMISSIONER OF HEALTH  SHALL,
    6  WITHIN  THE  FISCAL  YEAR  OF  TWO THOUSAND ELEVEN--TWO THOUSAND TWELVE,
    7  CONTRACT WITH QUALIFIED BIDDERS TO PERFORM PILOT PROJECTS TO ASSESS  THE
    8  FEASIBILITY  OF  REDUCING  MEDICALLY  UNNECESSARY HIGH COST RADIOLOGICAL
    9  PROCEDURES AND GENERALIZING COST SAVINGS TO THE STATE  THROUGH  ENHANCED
   10  MEDICAL MANAGEMENT AND PRIOR REVIEW OF ORDERS FOR DIAGNOSTIC IMAGING.
   11    2.  THE  COMMISSIONER OF HEALTH SHALL SELECT AN ENTITY TO PERFORM SUCH
   12  PILOT PROJECT UTILIZING THE FOLLOWING SELECTION CRITERIA:
   13    (A) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
   14  CURRENTLY  UTILIZING  LICENSED  PROFESSIONALS  TO  CONDUCT   INTAKE   OF
   15  PATIENTS;
   16    (B) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
   17  CURRENTLY  UTILIZING  ONLY  LICENSED  RADIOLOGISTS  TO MAKE PRIOR REVIEW
   18  DETERMINATIONS;
   19    (C) THE ENTITY SHALL HAVE AT LEAST ONE YEAR'S EXPERIENCE UTILIZING AND
   20  CURRENTLY UTILIZING LICENSED RADIOLOGISTS TO REQUEST ADDITIONAL INFORMA-
   21  TION, AS NECESSARY, FROM THE TREATING PROVIDER;
   22    (D) THE ENTITY SHALL BE BASED IN NEW YORK AND AT LEAST  FIFTY  PERCENT
   23  OF THE ENTITY'S EMPLOYEES SHALL RESIDE IN NEW YORK.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD06119-01-1
       A. 3080                             2
    1    S  2.  If any clause, sentence, paragraph, section or part of this act
    2  shall be adjudged by any court of competent jurisdiction to be  invalid,
    3  such  judgment  shall  not  affect,  impair, or invalidate the remainder
    4  thereof, but shall be confined in its operation to the clause, sentence,
    5  paragraph, section, or part thereof directly involved in the controversy
    6  in which such judgment shall have been rendered.
    7    S 3. This act shall take effect immediately.