NY State Senate Bill 2023-S1782

Current 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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Jan 13, 2023	referred to insurance

2023-S1782 (ACTIVE) - Details

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:: 2019-2020: S6790
2021-2022: S3506

2023-S1782 (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.

2023-S1782 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1782

SPONSOR: BAILEY
 
TITLE OF BILL:

An act to amend the insurance law and the public health law, in relation
to enacting the "health insurance preauthorization disclosure act"

 
PURPOSE:

This legislation would require health insurance companies to provide
participating physicians and health care providers with a list of treat-
ments and services that require preauthorization so that health care
providers can anticipate seeking authorization for such treatments and
deliver care more efficiently.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section I titles the bill.

Section I amends the insurance law by adding a new section 4242 which
stipulates that every health insurance company shall be required to

provide participating physicians and health care providers with an
updated list of health care treatments and services that require reau-
thorization from the insurance company.

Section III amends the public health law by adding new section 4905-a
which provides that every health care plan be required to develop and
provide to participating health care providers a list of health care
services that require pre-authorization or pre-certification from such
health care plan.

Section IV amends the insurance law by adding new section 4905-a which
provides that every health care plan be required to develop and provide
to participating health care providers a list of health care services
that require pre-authorization or pre-certification from such health
care plan.

Section V sets forth the effective date.

 
JUSTIFICATION:

Poor management and inefficiency in the health care industry has a nega-
tive effect on patient care, before a physician can authorize a test or
assessment for a physician they must get preauthorization from a health
care provider-a process that can take days. Very often early diagnosis
is imperative for patient care. If the circumstances are grave, patients
may not receive the care they need. By requiring insurers to provide a
list of treatments and services that require preauthorization, health
care providers can anticipate having to seek authorization for such
treatments and take the appropriate steps.

 
LEGISLATIVE HISTORY:

2021-22: S.3506 - Referred to Insurance

 
FISCAL IMPACT TO THE STATE:

None
 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become law.

2023-S1782 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1782
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2023
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 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.
                                                            LBD00709-01-3

 S. 1782                             2
 
 LIST OF HEALTH CARE SERVICES THAT REQUIRE PRE-AUTHORIZATION  OR  PRECER-
 TIFICATION  FROM  SUCH  HEALTH  CARE  PLAN. SUCH LIST SHALL BE DEVELOPED
 BASED UPON CONSULTATION WITH MEDICAL GUIDELINES DEVELOPED BY  THE  RELE-
 VANT  MEDICAL  SPECIALTY ORGANIZATION AND IN CONSULTATION WITH APPROPRI-
 ATELY TRAINED PHYSICIANS PRACTICING WITHIN THE REGION  THE  HEALTH  CARE
 PLAN  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 PLAN.  NO HEALTH CARE SERVICE SHALL BE ADDED TO THE LIST OF
 SERVICES REQUIRING  PRE-AUTHORIZATION  OR  PRECERTIFICATION  UNLESS  THE
 HEALTH CARE PLAN PROVIDES A MINIMUM OF NINETY DAYS NOTICE TO PARTICIPAT-
 ING HEALTH CARE PROVIDERS.
   §  4.  The  insurance 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
 LIST  OF  HEALTH CARE SERVICES THAT REQUIRE PRE-AUTHORIZATION OR PRECER-
 TIFICATION FROM SUCH HEALTH CARE PLAN.  SUCH  LIST  SHALL  BE  DEVELOPED
 BASED  UPON  CONSULTATION WITH MEDICAL GUIDELINES DEVELOPED BY THE RELE-
 VANT MEDICAL SPECIALTY ORGANIZATION AND IN CONSULTATION  WITH  APPROPRI-
 ATELY  TRAINED  PHYSICIANS  PRACTICING WITHIN THE REGION THE HEALTH CARE
 PLAN 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 PLAN.  NO HEALTH CARE SERVICE SHALL BE ADDED TO THE LIST  OF
 SERVICES  REQUIRING  PRE-AUTHORIZATION  OR  PRECERTIFICATION  UNLESS THE
 HEALTH CARE PLAN PROVIDES A MINIMUM OF NINETY DAYS NOTICE TO PARTICIPAT-
 ING HEALTH CARE PROVIDERS.
   § 5. This act shall take effect on the sixtieth  day  after  it  shall
 have become a law. Effective immediately the superintendent of financial
 services  is  hereby  authorized to promulgate all rules and regulations
 and take any other measures necessary to  implement  this  act  on  such
 effective date.

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Senate Bill S1782

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

2023-S1782 (ACTIVE) - Details

2023-S1782 (ACTIVE) - Summary

2023-S1782 (ACTIVE) - Sponsor Memo

2023-S1782 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S1782

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Sponsored By

Jamaal T. Bailey

Current Bill Status - In Senate Committee Insurance Committee

2023-S1782 (ACTIVE) - Details

2023-S1782 (ACTIVE) - Summary

2023-S1782 (ACTIVE) - Sponsor Memo

2023-S1782 (ACTIVE) - Bill Text download pdf

Comments