Senate Bill S6790

2019-2020 Legislative Session

Enacts the "health insurance preauthorization disclosure act"

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance 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

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2019-S6790 (ACTIVE) - Details

See Assembly Version of this Bill:
A1187
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §§4242 & 4905-a, Ins L; add §4905-a, Pub Health L
Versions Introduced in Other Legislative Sessions:
2009-2010: A8592
2011-2012: A199
2013-2014: A3520
2015-2016: A263, A9051
2017-2018: A1938
2021-2022: S3506, A5629
2023-2024: S1782, A842

2019-S6790 (ACTIVE) - Summary

Enacts the "health insurance preauthorization disclosure act"; requires health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company.

2019-S6790 (ACTIVE) - Sponsor Memo

2019-S6790 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6790
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             October 23, 2019
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law and the public health law, in relation
   to enacting the "health insurance preauthorization disclosure act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Short  title. This act shall be known and may be cited as
 the "health insurance preauthorization disclosure act".
   § 2. The insurance law is amended by adding a new section 4242 to read
 as follows:
   § 4242. HEALTH INSURANCE COMPANIES; PREAUTHORIZATION FOR  HEALTH  CARE
 SERVICES.  EVERY  HEALTH  CARE  INSURANCE  COMPANY  SHALL BE REQUIRED TO
 PROVIDE PARTICIPATING PHYSICIANS AND HEALTH CARE PROVIDERS,  AS  DEFINED
 IN SUBDIVISION SEVEN OF SECTION TWENTY-NINE HUNDRED EIGHTY OF THE PUBLIC
 HEALTH LAW, WITH AN UPDATED  LIST OF HEALTH CARE TREATMENTS AND SERVICES
 THAT  REQUIRE PREAUTHORIZATION OR PRECERTIFICATION FROM SUCH HEALTH CARE
 INSURANCE COMPANY.  SUCH LIST SHALL BE DEVELOPED BASED UPON CONSULTATION
 WITH MEDICAL GUIDELINES DEVELOPED  BY  THE  RELEVANT  MEDICAL  SPECIALTY
 ORGANIZATION  AND  IN CONSULTATION WITH APPROPRIATELY TRAINED PHYSICIANS
 PRACTICING WITHIN THE REGION THE HEALTH CARE INSURANCE  COMPANY  SERVES.
 SUCH  LIST  SHALL BE UPDATED ANNUALLY OR MORE FREQUENTLY AS APPROPRIATE.
 ONLY THOSE HEALTH CARE SERVICES WHICH ARE CONTAINED ON SUCH  LIST  SHALL
 BE  SUBJECT  TO PRE-AUTHORIZATION OR PRECERTIFICATION BY THE HEALTH CARE
 INSURANCE COMPANY. NO HEALTH CARE TREATMENT OR SERVICE SHALL BE ADDED TO
 THE LIST OF SERVICES  REQUIRING  PRE-AUTHORIZATION  OR  PRECERTIFICATION
 UNLESS  THE  HEALTH  CARE INSURANCE COMPANY PROVIDES A MINIMUM OF NINETY
 DAYS NOTICE TO PARTICIPATING PHYSICIANS AND HEALTH CARE PROVIDERS.
   § 3. The public health law is amended by adding a new  section  4905-a
 to read as follows:
   §  4905-A.  PRE-AUTHORIZED  SERVICES.  EVERY HEALTH CARE PLAN SHALL BE
 REQUIRED TO DEVELOP AND PROVIDE TO PARTICIPATING HEALTH CARE PROVIDERS A
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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