Relates to a medical assistance information and payment system; directs the department of health to issue a request for proposal for the purpose of providing the system within 90 days.
STATE OF NEW YORK
________________________________________________________________________
961
2011-2012 Regular Sessions
IN ASSEMBLY(Prefiled)
January 5, 2011
___________
Introduced by M. of A. DESTITO -- read once and referred to the Commit-
tee on Social Services
AN ACT to amend the social services law, in relation to a medical
assistance information and payment system
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph 2 of paragraph (b) of subdivision 8 of section
2 367-b of the social services law, as amended by chapter 109 of the laws
3 of 2007, is amended to read as follows:
4 (2) Coordination of benefits. Develop, test and implement an automated
5 process to improve the coordination of benefits between the medical
6 assistance program and other sources of coverage for medical assistance
7 recipients. Such initiative shall initially examine the savings poten-
8 tial to the medical assistance program through retrospective review of
9 claims paid which shall be completed not later than January thirty-
10 first, two thousand seven. If, based upon such initial experience, the
11 Medicaid inspector general deems the automated process to be capable of
12 including or moving to a prospective review, with negligible effect on
13 the turnaround of claims for provider payment or on recipient access to
14 services, then the Medicaid inspector general in subsequent tests shall
15 examine the savings potential through prospective, pre-claims payment
16 review. Provided, however, that the department of health shall imple-
17 ment an initiative establishing an automated real time prospective pre-
18 claims payment review process, including, but not limited to, a prior
19 pharmacy authorization and pre-pharmacy claims review of alternative
20 insurance coverage program, provided however that any such initiative
21 has minimal initial costs to the department of health. Any initiative
22 implemented by the department of health shall have a negligible effect
23 on the turnaround of claims for provider payment or on recipient access
24 to services and demonstrate savings potential.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01738-01-1
A. 961 2
1 § 2. The department of health shall issue a request for proposals for
2 the purpose of providing the system described in subparagraph (2) of
3 paragraph (b) of subdivision 8 of section 367-b of the social services
4 law, as amended by section one of this act, within 90 days of the effec-
5 tive date of this act. Bids from qualified vendors shall be received by
6 the department of health no later than 60 days following the issuance of
7 the request for proposals. Any contract issued pursuant to this section
8 shall be issued within 90 days following receipt of bids and installa-
9 tion of such system completed by the successful bidder within 180 days
10 of the issuance of such contract.
11 § 3. This act shall take effect immediately.
