Relates to insurance reimbursement for early intervention services for infants and toddlers with disabilities; provides that insurers and health plans shall not deny claims for such services due to lack of prior approval or out of network providers where such services are furnished pursuant to an early intervention individual family service plan.
STATE OF NEW YORK
________________________________________________________________________
4898
2011-2012 Regular Sessions
IN ASSEMBLY
February 9, 2011
___________
Introduced by M. of A. O'DONNELL -- read once and referred to the
Committee on Insurance
AN ACT to amend the public health law and the insurance law, in relation
to insurance reimbursement for early intervention services for infants
and toddlers with disabilities
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 3 of section 2559 of the public health law is
2 amended by adding a new paragraph (e) to read as follows:
3 (e) An insurer or health plan administrator shall accept the early
4 intervention individual family service plan as documentation of pre-au-
5 thorization and prior approval for such services to an eligible child.
6 All such services shall be considered "covered services". A qualified
7 provider of early intervention services, as defined in this article,
8 shall not be considered an out-of-network provider for purposes of
9 coverage under an insurance policy or health insurance plan.
10 § 2. Section 3235-a of the insurance law is amended by adding a new
11 subsection (e) to read as follows:
12 (e) No insurer, including a health maintenance organization issued a
13 certificate of authority under article forty-four of the public health
14 law and a corporation organized under article forty-three of this chap-
15 ter, shall refuse to accept the early intervention individual family
16 service plan as documentation of pre-authorization and prior approval
17 for such services to an eligible child. All such services shall be
18 considered "covered services". A qualified provider of early inter-
19 vention services, as defined in this article, shall not be considered an
20 out-of-network provider for purposes of coverage under an insurance
21 policy or health insurance plan.
22 § 3. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08979-01-1
