Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jun 03, 2022 |
committed to rules |
May 17, 2022 |
advanced to third reading |
May 16, 2022 |
2nd report cal. |
May 11, 2022 |
1st report cal.1334 |
Apr 26, 2022 |
print number 6435b |
Apr 26, 2022 |
amend and recommit to health |
Jan 05, 2022 |
referred to health |
Jun 10, 2021 |
committed to rules |
May 24, 2021 |
advanced to third reading |
May 20, 2021 |
2nd report cal. |
May 19, 2021 |
1st report cal.1228 |
May 04, 2021 |
print number 6435a |
May 04, 2021 |
amend (t) and recommit to health |
Apr 28, 2021 |
referred to health |
Senate Bill S6435B
2021-2022 Legislative Session
Sponsored By
(D, WF) 46th Senate District
Archive: Last Bill Status - In Senate Committee Rules 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
Votes
Bill Amendments
2021-S6435 - Details
- See Assembly Version of this Bill:
- A7129
- Current Committee:
- Senate Rules
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §§4902 & 4903, Pub Health L; amd §§4902, 4903 & 3238, Ins L
- Versions Introduced in Other Legislative Sessions:
-
2017-2018:
S7872, A9588
2019-2020: S2847, A3038
2023-2024: S3400, A7268
2021-S6435 - Sponsor Memo
BILL NUMBER: S6435 SPONSOR: BRESLIN TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to utilization review program standards and prescription drug formulary changes during a contract year, and in relation to pre-authorization of health care services PURPOSE OR GENERAL IDEA OF BILL: The purpose of this legislation is to reduce administrative requirements of health care practitioners which interfere with efforts to assure patients receive appropriate care by amending prior authorization and utilization ò review procedures imposed by insurance companies. SUMMARY OF PROVISIONS: Section 1 amends paragraph (c) of subdivision 1 of section 4902 of the public health law by adding "such clinical review criteria shall utilize
2021-S6435 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 6435 2021-2022 Regular Sessions I N S E N A T E April 28, 2021 ___________ Introduced by Sen. BRESLIN -- 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 utilization review program standards and prescription drug formu- lary changes during a contract year, and in relation to pre-authoriza- tion of health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (c) of subdivision 1 of section 4902 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: (c) Utilization of written clinical review criteria developed pursuant to a utilization review plan. SUCH CLINICAL REVIEW CRITERIA SHALL UTILIZE RECOGNIZED EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW CRITERIA THAT TAKES INTO ACCOUNT THE NEEDS OF A TYPICAL PATIENT POPU- LATIONS AND DIAGNOSES; § 2. Paragraph (a) of subdivision 2 of section 4903 of the public health law, as separately amended by section 13 of part YY and section 3 of part KKK of chapter 56 of the laws of 2020, is amended to read as follows: (a) A utilization review agent shall make a utilization review deter- mination involving health care services which require pre-authorization and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within [three business days] FORTY-EIGHT HOURS of receipt of the necessary information, WITHIN TWENTY-FOUR HOURS OF THE RECEIPT OF NECES- SARY INFORMATION IF THE REQUEST IS FOR AN ENROLLEE WITH A MEDICAL CONDI- TION THAT PLACES THE HEALTH OF THE INSURED IN SERIOUS JEOPARDY WITHOUT THE HEALTH CARE SERVICES RECOMMENDED BY THE ENROLLEE'S HEALTH CARE PROFESSIONAL, or for inpatient rehabilitation services following an inpatient hospital admission provided by a hospital or skilled nursing EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 30th Senate District
(R, C) 60th Senate District
(D, WF) Senate District
2021-S6435A - Details
- See Assembly Version of this Bill:
- A7129
- Current Committee:
- Senate Rules
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §§4902 & 4903, Pub Health L; amd §§4902, 4903 & 3238, Ins L
- Versions Introduced in Other Legislative Sessions:
-
2017-2018:
S7872, A9588
2019-2020: S2847, A3038
2023-2024: S3400, A7268
2021-S6435A - Sponsor Memo
BILL NUMBER: S6435A SPONSOR: BRESLIN TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to utilization review program standards, and in relation to pre-authori- zation of health care services TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to utilization review program standards, and in relation to pre-authori- zation of health care services PURPOSE OR GENERAL IDEA OF BILL: The purpose of this legislation is to reduce administrative requirements of health care practitioners which interfere with efforts to assure patients receive appropriate care by amending prior authorization and utilization ò review procedures imposed by insurance companies.
2021-S6435A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 6435--A 2021-2022 Regular Sessions I N S E N A T E April 28, 2021 ___________ Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law and the insurance law, in relation to utilization review program standards, and in relation to pre-au- thorization of health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (c) of subdivision 1 of section 4902 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: (c) Utilization of written clinical review criteria developed pursuant to a utilization review plan. SUCH CLINICAL REVIEW CRITERIA SHALL UTILIZE RECOGNIZED EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW CRITERIA THAT TAKE INTO ACCOUNT THE NEEDS OF A TYPICAL PATIENT POPU- LATIONS AND DIAGNOSES; § 2. Paragraph (a) of subdivision 2 of section 4903 of the public health law, as separately amended by section 13 of part YY and section 3 of part KKK of chapter 56 of the laws of 2020, is amended to read as follows: (a) A utilization review agent shall make a utilization review deter- mination involving health care services which require pre-authorization and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within [three business days] SEVENTY-TWO HOURS of receipt of the necessary information, WITHIN TWENTY-FOUR HOURS OF THE RECEIPT OF NECES- SARY INFORMATION IF THE REQUEST IS FOR AN ENROLLEE WITH A MEDICAL CONDI- TION THAT PLACES THE HEALTH OF THE INSURED IN SERIOUS JEOPARDY WITHOUT THE HEALTH CARE SERVICES RECOMMENDED BY THE ENROLLEE'S HEALTH CARE PROFESSIONAL, or for inpatient rehabilitation services following an EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 30th Senate District
(R, C) 60th Senate District
(D, WF) Senate District
2021-S6435B (ACTIVE) - Details
- See Assembly Version of this Bill:
- A7129
- Current Committee:
- Senate Rules
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §§4902 & 4903, Pub Health L; amd §§4902, 4903 & 3238, Ins L
- Versions Introduced in Other Legislative Sessions:
-
2017-2018:
S7872, A9588
2019-2020: S2847, A3038
2023-2024: S3400, A7268
2021-S6435B (ACTIVE) - Sponsor Memo
BILL NUMBER: S6435B SPONSOR: BRESLIN TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to utilization review program standards, and in relation to pre-authori- zation of health care services PURPOSE OR GENERAL IDEA OF BILL: The purpose of this legislation is to reduce administrative requirements of health care practitioners which interfere with efforts to assure patients receive appropriate care by amending prior authorization and utilization ò review procedures imposed by insurance companies. SUMMARY OF SPECIFIC PROVISIONS: Section 1 amends paragraph (c) of subdivision 1 of section 4902 of the public health law by adding "such clinical review criteria shall utilize recognized evidence-based and peer reviewed clinical review criteria that takes into account the needs of a typical patient populations and
2021-S6435B (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 6435--B 2021-2022 Regular Sessions I N S E N A T E April 28, 2021 ___________ Introduced by Sens. BRESLIN, CLEARE, GALLIVAN, KENNEDY -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law and the insurance law, in relation to utilization review program standards, and in relation to pre-au- thorization of health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (c) of subdivision 1 of section 4902 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: (c) Utilization of written clinical review criteria developed pursuant to a utilization review plan. SUCH CLINICAL REVIEW CRITERIA SHALL UTILIZE RECOGNIZED EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW CRITERIA THAT TAKE INTO ACCOUNT THE NEEDS OF A TYPICAL PATIENT POPU- LATIONS AND DIAGNOSES; § 2. Paragraph (a) of subdivision 2 of section 4903 of the public health law, as separately amended by section 13 of part YY and section 3 of part KKK of chapter 56 of the laws of 2020, is amended to read as follows: (a) A utilization review agent shall make a utilization review deter- mination involving health care services which require pre-authorization and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within [three business days] SEVENTY-TWO HOURS of receipt of the necessary information, WITHIN TWENTY-FOUR HOURS OF THE RECEIPT OF NECES- SARY INFORMATION IF THE REQUEST IS FOR AN ENROLLEE WITH A MEDICAL CONDI- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD03897-06-2
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