Bill Text: NY S05272 | 2013-2014 | General Assembly | Introduced

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Bill Title: Provides for the external utilization review of services provided pursuant to the fully integrated dual advantage program.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2014-01-08 - REFERRED TO HEALTH [S05272 Detail]

Download: New_York-2013-S05272-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         5272
                              2013-2014 Regular Sessions
                                   I N  S E N A T E
                                     May 15, 2013
                                      ___________
       Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
         printed to be committed to the Committee on Health
       AN ACT to amend the public health law and the insurance law, in relation
         to the right to external review of services provided pursuant  to  the
         fully integrated dual advantage program
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Section 4910 of the public health law is amended by  adding
    2  a new subdivision 5 to read as follows:
    3    5.  SUBJECT  TO  APPROVAL  BY  THE  CENTERS  FOR MEDICARE AND MEDICAID
    4  SERVICES, THE PROVISIONS OF THIS TITLE ARE APPLICABLE TO ADVERSE  DETER-
    5  MINATIONS MADE WITH RESPECT TO HEALTH CARE SERVICES PROVIDED TO INDIVID-
    6  UALS  ENROLLED  IN  THE  FULLY  INTEGRATED DUAL ADVANTAGE (FIDA) PROGRAM
    7  ESTABLISHED  PURSUANT  TO  SUBDIVISION  TWENTY-SEVEN  OF  SECTION  THREE
    8  HUNDRED  SIXTY-FOUR-J  OF  THE  SOCIAL SERVICES LAW, AS ADDED BY SECTION
    9  SEVENTY-TWO OF PART A OF CHAPTER FIFTY-SIX OF THE LAWS OF  TWO  THOUSAND
   10  THIRTEEN.
   11    S  2.  Section  4910  of  the insurance law is amended by adding a new
   12  subsection (e) to read as follows:
   13    (E) SUBJECT TO APPROVAL BY  THE  CENTERS  FOR  MEDICARE  AND  MEDICAID
   14  SERVICES,  THE PROVISIONS OF THIS TITLE ARE APPLICABLE TO ADVERSE DETER-
   15  MINATIONS MADE WITH RESPECT TO HEALTH CARE SERVICES PROVIDED TO INDIVID-
   16  UALS ENROLLED IN THE FULLY  INTEGRATED  DUAL  ADVANTAGE  (FIDA)  PROGRAM
   17  ESTABLISHED  PURSUANT  TO  SUBDIVISION  TWENTY-SEVEN  OF  SECTION  THREE
   18  HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW,  AS  ADDED  BY  SECTION
   19  SEVENTY-TWO  OF  PART A OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND
   20  THIRTEEN.
   21    S 3. This act shall take effect immediately.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10991-01-3