Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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---|---|
Jan 06, 2010 |
referred to insurance |
Jan 07, 2009 |
referred to insurance |
Assembly Bill A315
2009-2010 Legislative Session
Sponsored By
MAGNARELLI
Archive: Last Bill Status - In Assembly Committee
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
2009-A315 (ACTIVE) - Details
2009-A315 (ACTIVE) - Sponsor Memo
BILL NUMBER:A315 TITLE OF BILL: An act to amend the insurance law, in relation to prompt settlement of claims for health care and payments for health care services PURPOSE: To ensure that health care providers receive timely payment for services and support the delivery of health care services to the public. SUMMARY OF PROVISIONS: Amends Section 3224-a, subsections (a), (b), and (c) of the insurance law to (a) require that insurers make payments to health care providers within 30 days of receipt of a bill or claim for services rendered; (b) require insurers to pay undisputed portions of a bill or claim within 15 calendar days of receiving the claim, accommodate electric submission and tracking of claims information, and inform the provider that a claim has been denied within 15 calendar days of issuing the denial; and (c) specifies the penalties for violating this section of law. Amends Section 3224-a of the insurance law by adding a section (g) to allow policyholders or health care providers to commence legal action against an insurer for failure to comply with the provisions of this law. Adds a section (h) to Section 3224-a to provide that, every six months, insurers must prepare a list of claims for which they will always request operative notes and/or documentation of medical necessity
2009-A315 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 315 2009-2010 Regular Sessions I N A S S E M B L Y (PREFILED) January 7, 2009 ___________ Introduced by M. of A. MAGNARELLI, GALEF, JOHN, LUPARDO, MARKEY, ROBIN- SON -- Multi-Sponsored by -- M. of A. ALESSI, CHRISTENSEN, ESPAILLAT, HOOPER, McENENY, PHEFFER, WEISENBERG -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to prompt settlement of claims for health care and payments for health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsections (a), (b) and (c) of section 3224-a of the insurance law, as amended by chapter 666 of the laws of 1997, are amended to read as follows: (a) Except in a case where the obligation of an insurer or an organ- ization or corporation licensed or certified pursuant to article forty- three of this chapter or article forty-four of the public health law to pay a claim submitted by a policyholder or person covered under such policy or make a payment to a health care provider is not reasonably clear, or when there is a reasonable basis supported by specific infor- mation available for review by the superintendent that such claim or bill for health care services rendered was submitted fraudulently, such insurer or organization or corporation shall pay the claim to a policy- holder or covered person or make a payment to a health care provider within [forty-five] THIRTY days of receipt of a claim or bill for services rendered. (b) In a case where the obligation of an insurer or an organization or corporation licensed or certified pursuant to article forty-three of this chapter or article forty-four of the public health law to pay a claim or make a payment for health care services rendered is not reason- ably clear due to a good faith dispute regarding the eligibility of a person for coverage, the liability of another insurer or corporation or organization for all or part of the claim, the amount of the claim, the EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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