Promotes transparency and equity in the utilization review process by ensuring that agents are independent, having no existing relationships with the reviewed entity.
STATE OF NEW YORK
________________________________________________________________________
5927
2015-2016 Regular Sessions
IN SENATE
June 12, 2015
___________
Introduced by Sen. HAMILTON -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the public health law and the insurance law, in relation
to utilization review agents
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 4905 of the public health law is amended by adding
2 a new subdivision 16 to read as follows:
3 16. A utilization review agent shall not conduct a review of any enti-
4 ty in which it has "material familial affiliation", "material financial
5 affiliation" or "material professional affiliation".
6 § 2. Section 4905 of the insurance law is amended by adding a new
7 subsection (p) to read as follows:
8 (p) A utilization review agent shall not conduct a review of any enti-
9 ty in which it has "material familial affiliation", "material financial
10 affiliation" or "material professional affiliation".
11 § 3. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD11508-01-5
