Bill Text: NY A06022 | 2023-2024 | General Assembly | Amended


Bill Title: Requires periodic reviews of pending applications for material change in the coverage status of certain matters relative to new health technology assessment or medical evidence.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Introduced) 2024-01-03 - referred to ways and means [A06022 Detail]

Download: New_York-2023-A06022-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         6022--A

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     March 30, 2023
                                       ___________

        Introduced  by M. of A. PAULIN, SAYEGH, JENSEN -- read once and referred
          to the Committee on Health -- reported and referred to  the  Committee
          on  Ways  and  Means  --  committee  discharged, bill amended, ordered
          reprinted as amended and recommitted to said committee

        AN ACT to amend the social services law, in relation to requiring  peri-
          odic reviews of pending applications for material change in the cover-
          age  status  of  certain  matters  relative  to  new health technology
          assessment or medical evidence

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1. Subdivision 5 of section 365-d of the social services law,
     2  as added by section 46-a of part B of chapter 57 of the laws of 2015, is
     3  amended to read as follows:
     4    5. (a) The commissioner, in consultation  with  the  committee,  shall
     5  undertake  periodic  reviews of pending applications for material change
     6  in the coverage status  of  a  particular  item,  health  technology  or
     7  service,  and any matter relative to new health technology assessment or
     8  medical evidence for which an applicant has submitted a complete  appli-
     9  cation  to the department within three months of receipt. The department
    10  shall notify an  applicant  of  incompleteness  within  thirty  days  of
    11  receipt of submission. Receipt of applications shall be published on the
    12  department's  website  within  seven  days  of receipt. The commissioner
    13  shall schedule a review of such pending applications and cause  publica-
    14  tion of the date of review on the department's website within seven days
    15  of the review required by this paragraph.
    16    (b)  The commissioner, in consultation with the committee, shall issue
    17  a report to the chair of the standing committee on health in the  senate
    18  and  assembly  and publish the report on the department's website within
    19  thirty days of review of any pending application pursuant  to  paragraph
    20  (a)  of this subdivision. Such report shall provide the date of applica-
    21  tion, date of review, and  a  stated  determination  of  sufficiency  of

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08099-02-3

        A. 6022--A                          2

     1  evidence  warranting  committee  deliberation and recommendation. In the
     2  event of an affirmative determination of sufficiency  of  evidence,  the
     3  commissioner shall require the committee to issue a recommendation with-
     4  in  six  months  of such determination of sufficiency. In the event of a
     5  negative determination, the commissioner shall detail such insufficiency
     6  of evidence and allow the applicant  to  cure  stated  deficiencies  for
     7  review under the requirements provided in paragraph (a) of this subdivi-
     8  sion.
     9    (c) The committee shall consider any matter regarding material changes
    10  in  the  coverage  status  of  a  particular  item, health technology or
    11  service, and any matter relative to new health technology assessment  or
    12  medical evidence review for which the department determines a sufficient
    13  body  of  evidence exists to warrant committee deliberation. The commis-
    14  sioner shall provide members of  the  committee  with  any  evidence  or
    15  information  related to the health technology or medical service assess-
    16  ment including but not limited to, information submitted by  members  of
    17  the  public.  The  department shall report to the committee programmatic
    18  changes to benefits that do not rise to the level of a material  change,
    19  as  well as determinations of when sufficient medical evidence exists to
    20  warrant committee deliberations. The commissioner shall  provide  forty-
    21  five days public notice on the department's website prior to any meeting
    22  of the committee to develop recommendations concerning health technology
    23  or  medical service coverage determinations. Such notice shall include a
    24  description of the proposed health technology or service to be reviewed,
    25  the conditions or diseases impacted by the health technology or service,
    26  the proposals to be considered by  the  committee,  and  the  systematic
    27  evidence-based  assessment prepared in accordance with this subdivision.
    28  The committee shall allow interested parties a reasonable opportunity to
    29  make an oral presentation to the committee related to the  health  tech-
    30  nology or service to be reviewed and to submit written information.  The
    31  committee  shall  consider  any  information  provided by any interested
    32  party, including, but not limited to, health care providers, health care
    33  facilities, patients, consumers and manufacturers. For all health  tech-
    34  nologies  or  services selected for review, the department shall conduct
    35  or commission a systematic evidence-based assessment of the health tech-
    36  nology's or service's safety and clinical efficacy. The assessment shall
    37  use established systematic review elements,  study  quality  assessment,
    38  and  data  synthesis.  Upon  completion,  the systematic, evidence-based
    39  assessment shall be made available to the public.
    40    § 2. This act shall take effect immediately.
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