Bill Text: NY A09835 | 2015-2016 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relates to payments from the New York state medical indemnity fund.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2016-06-16 - substituted by s7873b [A09835 Detail]

Download: New_York-2015-A09835-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          9835
                   IN ASSEMBLY
                                     April 12, 2016
                                       ___________
        Introduced by M. of A. ABINANTI -- read once and referred to the Commit-
          tee on Health
        AN  ACT to amend the public health law, in relation to payments from the
          New York state medical indemnity fund
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Section  2999-j  of  the  public health law is amended by
     2  adding two new subdivisions 2-a and 7-a to read as follows:
     3    2-a. A request for review of a denial of a claim  or  a  denial  of  a
     4  request  for  prior  authorization for the payment or reimbursement from
     5  the fund for qualifying health care costs must be made by  the  claimant
     6  no later than sixty days from receipt of the denial and, at a claimant's
     7  option, by either (a) making application to the court wherein the judge-
     8  ment  was  awarded or the case was settled, or (b) following the process
     9  established by regulations of the commissioner  for  the  administrative
    10  review of a denial of a claim or request for prior authorization.
    11    7-a. A request for a review of a determination by the fund administra-
    12  tor that the relevant provisions of subdivision six of this section have
    13  not  been  met  and/or that the plaintiff or claimant is not a qualified
    14  plaintiff may be made by any of the parties, no later  than  sixty  days
    15  from  receipt  of the denial, by making application to the court wherein
    16  the judgment was awarded or the case was settled.
    17    § 2. Subdivisions 2 and 4 of section 2999-j of the public health  law,
    18  as  added by section 52 of part H of chapter 59 of the laws of 2011, are
    19  amended to read as follows:
    20    2. The provision of qualifying health care costs to  qualified  plain-
    21  tiffs  shall  not be subject to prior authorization, except as described
    22  by the commissioner in regulation; provided, however,  that  such  regu-
    23  lation  shall  not  prevent  qualified plaintiffs from receiving care or
    24  assistance that would, at a minimum, be authorized  under  the  medicaid
    25  program;  and  provided,  further,  that  if  any prior authorization is
    26  required by such regulation, the regulation shall require that  requests
    27  for  prior  authorization be processed within a reasonably prompt period
    28  of time and, subject to the provisions  of  subdivision  two-a  of  this
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14645-03-6