S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7520

                            I N  S E N A T E

                             April 19, 2010
                               ___________

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 social  services  law,  in  relation  to  a  medical
  assistance information and payment system

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph 2 of paragraph (b) of subdivision 8 of section
367-b of the social services law, as amended by chapter 109 of the  laws
of 2007, is amended to read as follows:
  (2) Coordination of benefits. Develop, test and implement an automated
process  to  improve  the  coordination  of benefits between the medical
assistance program and other sources of coverage for medical  assistance
recipients.  Such  initiative shall initially examine the savings poten-
tial to the medical assistance program through retrospective  review  of
claims  paid  which  shall  be  completed not later than January thirty-
first, two thousand seven. If, based upon such initial  experience,  the
Medicaid  inspector general deems the automated process to be capable of
including or moving to a prospective review, with negligible  effect  on
the  turnaround of claims for provider payment or on recipient access to
services, then the Medicaid inspector general in subsequent tests  shall
examine  the  savings  potential through prospective, pre-claims payment
review.  PROVIDED, HOWEVER, THAT THE DEPARTMENT OF HEALTH  SHALL  IMPLE-
MENT  AN INITIATIVE ESTABLISHING AN AUTOMATED REAL TIME PROSPECTIVE PRE-
CLAIMS PAYMENT REVIEW PROCESS, INCLUDING, BUT NOT LIMITED  TO,  A  PRIOR
PHARMACY  AUTHORIZATION  AND  PRE-PHARMACY  CLAIMS REVIEW OF ALTERNATIVE
INSURANCE COVERAGE PROGRAM, PROVIDED HOWEVER THAT  ANY  SUCH  INITIATIVE
HAS  MINIMAL  INITIAL  COSTS TO THE DEPARTMENT OF HEALTH. ANY INITIATIVE
IMPLEMENTED BY THE DEPARTMENT OF HEALTH SHALL HAVE A  NEGLIGIBLE  EFFECT
ON  THE TURNAROUND OF CLAIMS FOR PROVIDER PAYMENT OR ON RECIPIENT ACCESS
TO SERVICES AND DEMONSTRATE SAVINGS POTENTIAL.
  S 2. The department of health shall issue a request for  proposal  for
the  purpose  of  providing  the system described in subparagraph (2) of
paragraph (b) of subdivision 8 of section 367-b of the  social  services
law, as amended by section one of this act, within 90 days of the effec-

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

                                                           LBD14345-02-9

S. 7520                             2

tive  date of this act. Bids from qualified vendors shall be received by
the department of health no later than 60 days following the issuance of
the request for proposal. Any contract issued pursuant to  this  section
shall  be  issued within 90 days following receipt of bids and installa-
tion of such system completed by the successful bidder within  180  days
of the issuance of such contract.
  S 3. This act shall take effect immediately.