NY State Senate Bill 2023-S7049A

Current Bill Status - In Senate Committee Health 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
May 23, 2024	print number 7049a
May 23, 2024	amend and recommit to health
Jan 03, 2024	referred to health
May 17, 2023	referred to health

Bill Amendments

Original

A (Active)

2023-S7049 - Details

See Assembly Version of this Bill:: A10301
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2999-j & 2999-i, Pub Health L

2023-S7049 - Summary

Requires any regulation that mandates prior authorization to establish a mechanism for submission of requests for prior authorization by health care providers directly to the medical indemnity fund; requires the medical indemnity fund administrator to notify qualified plaintiffs which costs are qualifying health care costs to be paid from the fund and which are not within a reasonably prompt period of time.

2023-S7049 - Sponsor Memo

                                 
BILL NUMBER: S7049

SPONSOR: SKOUFIS
 
TITLE OF BILL:

An act to amend the public health law, in relation to prior authori-
zation and payments from the medical indemnity fund

 
PURPOSE:

To improve and streamline the prior authorization process and general
user experience of the medical indemnity fund.

 
SUMMARY OF PROVISIONS:

Section 1: Amends § 2999-j of the public health law to allow prior
authorization forms to be submitted directly through health care provid-
ers.

Section 2: Requires that a summary of costs that qualified and did not
qualify be delivered to the qualified plaintiff after claim.

Section 3: Provides the effective date.

 
JUSTIFICATION:

The NYS Medical Indemnity Fund (MIF) is a program designed to ensure
that patients who have experienced medical errors or negligence (medical
malpractice) have access to compensation. The MIF is currently overseen
by New York State Department of Financial Services (DFS) as well as the
Public Consulting Group. The MIF provides an additional source of fund-
ing to address eligible claims that exceed primary coverage limits,
ensuring that patients can seek appropriate compensation for injuries
resulting from medical malpractice.

The issue this bill tackles was brought by a group of New Yorkers who
described using the MIF as having a "second full-time job." This bill
will make the Medical Indemnity Fund (MIF) more user friendly, thus
ensuring that qualified plaintiffs receive what they are owed.

First, this bill would require that the Public Consulting Group accept
prior authorization forms directly from healthcare providers akin to how
every other insurance company does. Second, This bill would require that
for all claims the claimant is notified what is a qualifying health care
cost that can be paid from the fund. This is to make it easier for the
guardians of qualified plaintiffs to keep track of how much and what
parts of their claims are being paid out of the fund.

 
LEGISLATIVE HISTORY:

New Bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect ninety days after it shall become a law.

2023-S7049 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7049
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               May 17, 2023
                                ___________
 
 Introduced  by  Sen. SKOUFIS -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in  relation  to  prior  authori-
   zation and payments from the medical indemnity fund
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision 2 of  section  2999-j  of  the
 public  health  law,  as amended by section 3 of part K of chapter 57 of
 the laws of 2019, is amended and a new paragraph (b-1) is added to  read
 as follows:
   (b)  if  any  prior  authorization is required by such regulation, the
 regulation shall require that requests for prior authorization be  proc-
 essed  within  a  reasonably  prompt period of time and shall identify a
 process for prompt administrative review of any denial of a request  for
 prior authorization; [and]
   (B-1)  IF  ANY PRIOR AUTHORIZATION IS REQUIRED BY SUCH REGULATION, THE
 REGULATION SHALL REQUIRE ESTABLISHING  A  MECHANISM  FOR  SUBMISSION  OF
 REQUESTS  FOR  PRIOR  AUTHORIZATION BY HEALTH CARE PROVIDERS DIRECTLY TO
 THE FUND; AND
   § 2. Paragraph (b) of subdivision 8 of section 2999-j  of  the  public
 health  law,  as added by section 52 of part H of chapter 59 of the laws
 of 2011, is amended and a new paragraph (c) is added to read as follows:
   (b) thereupon certify to the  commissioner  of  taxation  and  finance
 those costs that have been determined to be qualifying health care costs
 to be paid from the fund[.]; AND
   (C)  NOTIFY THE QUALIFIED PLAINTIFF WHICH OF SUCH COSTS ARE QUALIFYING
 HEALTH CARE COSTS TO BE PAID FROM THE FUND  ALONG  WITH  WHICH  OF  SUCH
 COSTS ARE NOT QUALIFYING HEALTH CARE COSTS TO BE PAID FROM THE FUND IN A
 REASONABLY PROMPT PERIOD OF TIME.
   §  3.  This  act shall take effect on the ninetieth day after it shall
 have become a law.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11112-01-3

co-Sponsors

2023-S7049A (ACTIVE) - Details

See Assembly Version of this Bill:: A10301
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2999-j & 2999-i, Pub Health L

2023-S7049A (ACTIVE) - Summary

2023-S7049A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S7049A

SPONSOR: SKOUFIS
 
TITLE OF BILL:

An act to amend the public health law, in relation to prior authori-
zation and payments from the medical indemnity fund

 
PURPOSE:

To improve and streamline the prior authorization process and general
user experience of the medical indemnity fund and ensure the medical
indemnity fund is properly funded during the 2024-2025 fiscal year and
beyond.

 
SUMMARY OF PROVISIONS:

Section 1: Amends § 2999-j of the public health law to allow prior
authorization forms to be submitted directly through health care provid-
ers.

Section 2: Requires that a summary of costs be delivered to the quali-

fied plaintiff after claim.

Section 3: Amends § 2999-i((5) to provide that beginning April 1, 2025,
the commissioner shall all deposit an amount equal to the funding level
necessary to ensure the liabilities of the fund do not equal or exceed
eighty percent of the fund's assets as determined by the required actu-
arial calculations. Amends § 2999-i(6)(a) to require the commissioner to
conduct an actuarial calculation of the estimated liabilities of the
fund for the coming year no later than sixty days following the deposit-
ed referenced in subdivision five of this section and require quarterly
actuarial calculations, with the public posting of such actuarial calcu-
lations within thirty days of completion. Requires 60 days' prior notice
of suspension whenever suspension is triggered.

Requires the fund to continue to accept new enrollments during the
fiscal year beginning April 1, 2024 and ending March 31,.2025, provided
the total of all estimates of current liabilities equals or exceeds
ninety percent of the fund's assets.

 
JUSTIFICATION:

The NYS Medical Indemnity Fund (MIF) is a program designed to provide a
funding source for future health care costs associated with birth
related neurological injuries, in order to reduce premium costs for
medical malpractice insurance coverage. The MIF is currently overseen by
the New York State Department Health (DOH).

This bill will make the Medical Indemnity Fund (MIF) more user friendly,
thus, ensuring that qualified plaintiffs receive what they are owed.

First, this bill would require that the fund administrator accept prior
authorization forms directly from healthcare providers akin to how every
other insurance company does. Second, this bill would also require that
for all claims the claimant is notified what is a qualifying health care
cost that can be paid from the fund. This is to make it easier for the
guardians of qualified plaintiffs to keep track of how much and what
parts of their claims are being paid out of the fund.
This bill would also address the chronic underfunding of the medical
indemnity fund that has recently resulted in the fund being suspended
for new enrollments. It would require the commissioner to deposit enough
funding each year, beginning with the fiscal year beginning April 1,
2025, to ensure the liabilities of the fund do not equal or exceed
eighty percent of the fund's assets, which is the current trigger for
suspension. This is necessary to ensure the fund remains solvent and
able to achieve its statutory purposes into the future.

Because the fund was suspended approximately two weeks after the
2024-2025 budget was completed, there has been confusion among affected
stakeholders who had no ability to prepare. This bill would keep the
fund open until March 31,2025. The issue can be solved in the SFY25-26
final budget,

 
LEGISLATIVE HISTORY:

New Bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately; provided however that sections
one and two of this act shall take effect on the ninetieth days after it
shall become a law.

2023-S7049A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7049--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               May 17, 2023
                                ___________
 
 Introduced  by  Sen. SKOUFIS -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health --  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, in relation to prior authori-
   zation and payments from the medical indemnity fund
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of subdivision 2 of section 2999-j of the
 public health law, as amended by section 3 of part K of  chapter  57  of
 the  laws of 2019, is amended and a new paragraph (b-1) is added to read
 as follows:
   (b) if any prior authorization is required  by  such  regulation,  the
 regulation  shall require that requests for prior authorization be proc-
 essed within a reasonably prompt period of time  and  shall  identify  a
 process  for prompt administrative review of any denial of a request for
 prior authorization; [and]
   (B-1) IF ANY PRIOR AUTHORIZATION IS REQUIRED BY SUCH  REGULATION,  THE
 REGULATION  SHALL  REQUIRE  ESTABLISHING  A  MECHANISM FOR SUBMISSION OF
 REQUESTS FOR PRIOR AUTHORIZATION BY HEALTH CARE  PROVIDERS  DIRECTLY  TO
 THE FUND; AND
   §  2.  Paragraph  (b) of subdivision 8 of section 2999-j of the public
 health law, as added by section 52 of part H of chapter 59 of  the  laws
 of 2011, is amended and a new paragraph (c) is added to read as follows:
   (b)  thereupon  certify  to  the  commissioner of taxation and finance
 those costs that have been determined to be qualifying health care costs
 to be paid from the fund[.]; AND
   (C) NOTIFY THE QUALIFIED PLAINTIFF WHICH OF SUCH COSTS ARE  QUALIFYING
 HEALTH  CARE  COSTS  TO  BE  PAID FROM THE FUND ALONG WITH WHICH OF SUCH

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11112-05-4
 S. 7049--A                          2

 
 COSTS ARE NOT QUALIFYING HEALTH CARE COSTS TO BE PAID FROM THE FUND IN A
 REASONABLY PROMPT PERIOD OF TIME.
   §  3.  Subdivision  5  and  paragraph  (a) of subdivision 6 of section
 2999-i of the public health law, as amended by section 2 of  part  K  of
 chapter 57 of the laws of 2019, are amended to read as follows:
   5. For the state fiscal year beginning April first, two thousand elev-
 en  and ending March thirty-first, two thousand twelve, the state fiscal
 year beginning April first, two thousand twelve and ending  March  thir-
 ty-first,  two  thousand  thirteen,  and the state fiscal year beginning
 April first, two thousand thirteen and ending  March  thirty-first,  two
 thousand  fourteen, the superintendent of financial services shall cause
 to be deposited into the fund for  each  such  fiscal  year  the  amount
 appropriated for such purpose. Beginning April first, two thousand four-
 teen  and  annually thereafter, the superintendent of financial services
 or the commissioner, whoever is administering the fund for the  applica-
 ble  period shall cause to be deposited into the fund, subject to avail-
 able appropriations, an amount  equal  to  the  difference  between  the
 amount appropriated to the fund in the preceding fiscal year[,].  BEGIN-
 NING  APRIL FIRST, TWO THOUSAND TWENTY-FIVE, THE COMMISSIONER OR WHOEVER
 IS ADMINISTERING THE FUND FOR THE APPLICABLE PERIOD SHALL  CAUSE  TO  BE
 DEPOSITED  INTO  THE FUND AN AMOUNT EQUAL TO THE FUNDING LEVEL NECESSARY
 TO ENSURE THE LIABILITIES OF THE MEDICAL INDEMNITY FUND DO NOT EQUAL  OR
 EXCEED EIGHTY PERCENT OF THE FUND'S ASSETS AS DETERMINED IN THE ACTUARI-
 AL  CALCULATION  SET  FORTH  IN PARAGRAPH (A) OF SUBDIVISION SIX OF THIS
 SECTION, as increased by the adjustment factor  defined  in  subdivision
 seven  of this section[, and the assets of the fund at the conclusion of
 that fiscal year].
   (a) [Following] NO LATER THAN SIXTY DAYS FOLLOWING the deposit  refer-
 enced  in  subdivision  five  of  this  section,  the commissioner shall
 conduct an actuarial calculation of the  estimated  liabilities  of  the
 fund  for  the  coming  year  resulting  from  the  qualified plaintiffs
 enrolled in the fund AND SHALL ALSO CONDUCT QUARTERLY  ACTUARIAL  CALCU-
 LATIONS. THE DEPARTMENT SHALL PUBLICLY POST ON ITS WEBSITE SUCH ACTUARI-
 AL  CALCULATIONS  WITHIN  THIRTY DAYS OF COMPLETION.   The administrator
 shall from time to time  adjust  such  calculation  in  accordance  with
 subdivision  seven  of  this  section.  If the total of all estimates of
 current liabilities equals or  exceeds  eighty  percent  of  the  fund's
 assets,  then  the fund shall not accept any new enrollments until a new
 deposit has been made pursuant to  subdivision  five  of  this  section,
 PROVIDED HOWEVER, THE DEPARTMENT SHALL PROVIDE SIXTY DAYS' NOTICE ON ITS
 WEBSITE BEFORE THE FUND SUSPENDS ENROLLMENTS.  When, as a result of such
 new  deposit,  the fund's liabilities no longer exceed eighty percent of
 the fund's assets, the fund administrator  shall  enroll  new  qualified
 plaintiffs  in  the  order  that  an application for enrollment has been
 submitted in accordance with subdivision seven  of  section  twenty-nine
 hundred   ninety-nine-j  of  this  title.    NOTWITHSTANDING  ANY  OTHER
 PROVISION OF THIS SECTION, FOR THE STATE  FISCAL  YEAR  BEGINNING  APRIL
 FIRST, TWO THOUSAND TWENTY-FOUR AND ENDING MARCH THIRTY-FIRST, TWO THOU-
 SAND TWENTY-FIVE, THE FUND SHALL CONTINUE TO ACCEPT NEW ENROLLMENTS.
   §  4.  This act shall take effect immediately; provided, however, that
 sections one and two of this act shall take effect on the ninetieth  day
 after it shall have become a law.

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Senate Bill S7049A

Sponsored By

Current Bill Status - In Senate Committee Health Committee

Bill Amendments

2023-S7049 - Details

2023-S7049 - Summary

2023-S7049 - Sponsor Memo

2023-S7049 - Bill Text download pdf

co-Sponsors

2023-S7049A (ACTIVE) - Details

2023-S7049A (ACTIVE) - Summary

2023-S7049A (ACTIVE) - Sponsor Memo

2023-S7049A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S7049A

Share this bill

Sponsored By

James Skoufis

Current Bill Status - In Senate Committee Health Committee

Bill Amendments

2023-S7049 - Details

2023-S7049 - Summary

2023-S7049 - Sponsor Memo

2023-S7049 - Bill Text download pdf

co-Sponsors

Robert Jackson

2023-S7049A (ACTIVE) - Details

2023-S7049A (ACTIVE) - Summary

2023-S7049A (ACTIVE) - Sponsor Memo

2023-S7049A (ACTIVE) - Bill Text download pdf

Comments