Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
May 22, 2024 |
reported referred to rules |
May 17, 2024 |
print number 7268a |
May 17, 2024 |
amend (t) and recommit to insurance |
Jan 03, 2024 |
referred to insurance |
May 16, 2023 |
referred to insurance |
Assembly Bill A7268A
2023-2024 Legislative Session
Sponsored By
WEPRIN
Current 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
Bill Amendments
co-Sponsors
Carrie Woerner
Al Taylor
Angelo Santabarbara
William Colton
2023-A7268 - Details
2023-A7268 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7268 2023-2024 Regular Sessions I N A S S E M B L Y May 16, 2023 ___________ Introduced by M. of A. WEPRIN, WOERNER, TAYLOR, SANTABARBARA, COLTON, LUPARDO, STIRPE, EPSTEIN, PAULIN, NORRIS, SEAWRIGHT, SIMON, JOYNER, LAVINE, STECK, TANNOUSIS, WALLACE, GUNTHER, L. ROSENTHAL, MEEKS, DAVI- LA, WILLIAMS, SILLITTI -- read once and referred to the Committee on Insurance 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08333-01-3
co-Sponsors
Carrie Woerner
Al Taylor
Angelo Santabarbara
William Colton
2023-A7268A (ACTIVE) - Details
2023-A7268A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7268--A 2023-2024 Regular Sessions I N A S S E M B L Y May 16, 2023 ___________ Introduced by M. of A. WEPRIN, WOERNER, TAYLOR, SANTABARBARA, COLTON, LUPARDO, STIRPE, EPSTEIN, PAULIN, NORRIS, SEAWRIGHT, SIMON, LAVINE, STECK, TANNOUSIS, WALLACE, GUNTHER, L. ROSENTHAL, MEEKS, DAVILA, WILLIAMS, SILLITTI, ARDILA, LUNSFORD, BORES, PIROZZOLO, KELLES, CARROLL, SIMPSON, BENDETT, REYES, ANGELINO, SAYEGH, THIELE, LEVENBERG, SOLAGES, RAMOS, DiPIETRO, GALLAHAN, RAGA, HEVESI, CLARK, SHRESTHA -- read once and referred to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -- 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 pre-authorization 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08333-02-4
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