Directs the superintendent of financial services in conjunction with the commissioner of health to conduct an analysis of standards and enforcement provisions for prompt and equitable settlement of claims for payment of home care services.
STATE OF NEW YORK
________________________________________________________________________
7960
IN SENATE
May 31, 2016
___________
Introduced by Sen. SEWARD -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT directing the superintendent of financial services to conduct an
analysis of standards and enforcement provisions for prompt and equi-
table settlement of claims for payment of home care services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The superintendent of the department of financial services,
2 in conjunction with the commissioner of health, shall conduct an analy-
3 sis of the standards for prompt, fair and equitable settlement of claims
4 and payments for home care services as required under section 3224-a of
5 the insurance law. Such analysis shall include: (i) an examination of
6 current practices and compliance with the provisions of such law; (ii)
7 an examination as to whether modifications to such law are necessary for
8 addressing circumstances specific to home care, and the increasing shift
9 of health care services from institutional settings to home care, in
10 order to ensure that home care agencies submitting claims and authori-
11 zation requests for services to insurance and medical assistance benefi-
12 ciaries receive prompt, equitable and fair settlement of claims and
13 payment; and (iii) recommendations for statutory, regulatory, procedural
14 or enforcement improvement. In conducting such analysis, such super-
15 intendent and such commissioner shall consider the input of represen-
16 tatives of home care agencies, licensed health insurers, health mainte-
17 nance organizations, managed care plans under section 364-j of the
18 social services law, managed long term care plans under section 4403-f
19 of the public health law, consumers, and statewide associations repre-
20 sentative of such home care agencies, insurer, organizations, plans and
21 consumers. Such superintendent and commissioner shall report to the
22 chairs of the senate and assembly insurance committees and the senate
23 and assembly health committees no later than one year after the effec-
24 tive date of this act, and shall include the input received from the
25 required consultation entities.
26 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD15573-02-6
