- Summary
- Actions
- Committee Votes
- Floor Votes
- Memo
- Text
- LFIN
- Chamber Video/Transcript
S05328 Summary:
BILL NO | S05328A |
  | |
SAME AS | SAME AS A02880-B |
  | |
SPONSOR | BRESLIN |
  | |
COSPNSR | METZGER |
  | |
MLTSPNSR | |
  | |
Rpld & add §3238 sub§ (c), Ins L | |
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Relates to denial of coverage of additional or related services or procedures related to health care services for which pre-authorization was granted or did not require pre-authorization. |
S05328 Actions:
BILL NO | S05328A | |||||||||||||||||||||||||||||||||||||||||||||||||
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04/26/2019 | REFERRED TO INSURANCE | |||||||||||||||||||||||||||||||||||||||||||||||||
06/14/2019 | AMEND (T) AND RECOMMIT TO INSURANCE | |||||||||||||||||||||||||||||||||||||||||||||||||
06/14/2019 | PRINT NUMBER 5328A | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2019 | COMMITTEE DISCHARGED AND COMMITTED TO RULES | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2019 | ORDERED TO THIRD READING CAL.1509 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2019 | PASSED SENATE | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2019 | DELIVERED TO ASSEMBLY | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2019 | referred to codes | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2019 | substituted for a2880b | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2019 | ordered to third reading cal.493 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2019 | passed assembly | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2019 | returned to senate | |||||||||||||||||||||||||||||||||||||||||||||||||
12/06/2019 | DELIVERED TO GOVERNOR | |||||||||||||||||||||||||||||||||||||||||||||||||
12/12/2019 | SIGNED CHAP.640 |
S05328 Committee Votes:
Go to topS05328 Floor Votes:
Yes
Abbate
Yes
Crespo
ER
Gantt
Yes
LiPetri
Yes
Perry
Yes
Simon
Yes
Abinanti
Yes
Crouch
Yes
Garbarino
Yes
Lupardo
Yes
Pheffer Amato
Yes
Simotas
Yes
Arroyo
Yes
Cruz
Yes
Giglio
Yes
Magnarelli
Yes
Pichardo
Yes
Smith
Yes
Ashby
Yes
Cusick
Yes
Glick
Yes
Malliotakis
Yes
Pretlow
Yes
Smullen
Yes
Aubry
Yes
Cymbrowitz
Yes
Goodell
Yes
Manktelow
Yes
Quart
Yes
Solages
Yes
Barclay
Yes
Davila
Yes
Gottfried
Yes
McDonald
Yes
Ra
Yes
Stec
Yes
Barnwell
Yes
De La Rosa
Yes
Griffin
Yes
McDonough
Yes
Raia
Yes
Steck
Yes
Barrett
Yes
DenDekker
Yes
Gunther
Yes
McMahon
Yes
Ramos
Yes
Stern
Yes
Barron
Yes
DeStefano
Yes
Hawley
Yes
Mikulin
Yes
Raynor
Yes
Stirpe
Yes
Benedetto
Yes
Dickens
Yes
Hevesi
Yes
Miller B
Yes
Reilly
Yes
Tague
Yes
Bichotte
Yes
Dilan
Yes
Hunter
Yes
Miller MG
Yes
Reyes
Yes
Taylor
Yes
Blake
Yes
Dinowitz
Yes
Hyndman
Yes
Miller ML
Yes
Richardson
Yes
Thiele
Yes
Blankenbush
Yes
DiPietro
Yes
Jacobson
Yes
Montesano
Yes
Rivera
Yes
Titus
Yes
Brabenec
Yes
D'Urso
Yes
Jaffee
Yes
Morinello
Yes
Rodriguez
Yes
Vanel
Yes
Braunstein
Yes
Eichenstein
Yes
Jean-Pierre
Yes
Mosley
Yes
Romeo
Yes
Walczyk
Yes
Bronson
Yes
Englebright
Yes
Johns
Yes
Niou
Yes
Rosenthal D
Yes
Walker
Yes
Buchwald
Yes
Epstein
Yes
Jones
Yes
Nolan
Yes
Rosenthal L
Yes
Wallace
Yes
Burke
Yes
Fahy
Yes
Joyner
Yes
Norris
Yes
Rozic
Yes
Walsh
Yes
Buttenschon
Yes
Fall
Yes
Kim
Yes
O'Donnell
Yes
Ryan
Yes
Weinstein
Yes
Byrne
Yes
Fernandez
Yes
Kolb
Yes
Ortiz
Yes
Salka
Yes
Weprin
Yes
Byrnes
Yes
Finch
Yes
Lalor
Yes
Otis
Yes
Santabarbara
Yes
Williams
Yes
Cahill
Yes
Fitzpatrick
Yes
Lavine
Yes
Palmesano
Yes
Sayegh
Yes
Woerner
Yes
Carroll
Yes
Friend
Yes
Lawrence
Yes
Palumbo
Yes
Schimminger
Yes
Wright
Yes
Colton
Yes
Frontus
Yes
Lentol
Yes
Paulin
Yes
Schmitt
Yes
Zebrowski
Yes
Cook
Yes
Galef
Yes
Lifton
Yes
Peoples-Stokes
Yes
Seawright
Yes
Mr. Speaker
‡ Indicates voting via videoconference
S05328 Text:
Go to top STATE OF NEW YORK ________________________________________________________________________ 5328--A 2019-2020 Regular Sessions IN SENATE April 26, 2019 ___________ Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to denial of coverage of additional or related services or procedures related to health care services for which pre-authorization was granted or did not require pre-authorization; and to repeal certain provisions of such law relat- ing thereto The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (c) of section 3238 of the insurance law is 2 REPEALED and a new subsection (c) is added to read as follows: 3 (c)(1) If a health care provider, while providing a service or proce- 4 dure to treat a patient, determines that providing an additional or 5 related service or procedure, such as a service or procedure to address 6 a co-morbid condition, is immediately necessary as part of such treat- 7 ment, and in the clinical judgment of the health care provider it is a 8 medically timely service and it would not be medically advisable to 9 interrupt the provision of care to the patient in order to obtain pre- 10 authorization from a health plan for the additional or related service 11 or procedure, a denial of payment for the additional or related service 12 or procedure due to lack of pre-authorization shall be upheld on appeal 13 only if it is determined that: 14 (i) the additional or related service or procedure is not a covered 15 benefit; 16 (ii) the additional or related service or procedure was not medically 17 necessary pursuant to section four thousand nine hundred four of this 18 chapter or section forty-nine hundred four of the public health law; 19 (iii) the additional or related service or procedure was experimental 20 or investigational pursuant to section four thousand nine hundred four EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04761-06-9S. 5328--A 2 1 of this chapter or section forty-nine hundred four of the public health 2 law; or 3 (iv) one of the conditions set forth in paragraphs one through six of 4 subsection (a) of this section is met. 5 (2) The provisions of this subsection shall apply to situations in 6 which pre-authorization was required and received for the initial 7 service or procedure. 8 (3) The provisions of this subsection shall apply without regard to 9 whether the current procedural terminology (CPT) code for the additional 10 or related service or procedure is different than the CPT code for the 11 initial service or procedure. 12 § 2. This act shall take effect on the ninetieth day after it shall 13 have become a law.