Bill Text: NY A08195 | 2013-2014 | General Assembly | Amended

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Bill Title: Relates to financial responsibility and reimbursement for payment for early intervention services.

Spectrum: Moderate Partisan Bill (Democrat 20-6)

Status: (Introduced - Dead) 2014-02-10 - print number 8195a [A08195 Detail]

Download: New_York-2013-A08195-Amended.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        8195--A
                              2013-2014 Regular Sessions
                                 I N  A S S E M B L Y
                                    October 4, 2013
                                      ___________
       Introduced  by M. of A. FAHY, GOTTFRIED, STECK, WEPRIN, JAFFEE, GUNTHER,
         BUCHWALD, SKOUFIS, LUPARDO, DUPREY, TEDISCO, O'DONNELL, SCHIMEL, WEIS-
         ENBERG, ZEBROWSKI, COLTON, GALEF, LIFTON, DIPIETRO,  JOHNS,  MAYER  --
         Multi-Sponsored  by -- M. of A. BRENNAN, CROUCH, ENGLEBRIGHT, McLAUGH-
         LIN, SEPULVEDA -- read once and referred to the Committee on Health --
         recommitted to the Committee on Health  in  accordance  with  Assembly
         Rule  3,  sec.  2  --  committee  discharged,  bill  amended,  ordered
         reprinted as amended and recommitted to said committee
       AN ACT to amend the public health law, in relation to financial  respon-
         sibility and reimbursement for payment for early intervention services
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. The opening paragraph of paragraph (a) of subdivision 3  of
    2  section  2559 of the public health law, as amended by section 11 of part
    3  A of chapter 56 of the laws of 2012, is amended to read as follows:
    4    [Providers of evaluations and early intervention services, hereinafter
    5  collectively referred to in this subdivision as "provider"  or  "provid-
    6  ers",]  THE  STATE,  OR  ITS  DESIGNATED FISCAL AGENT shall in the first
    7  instance and where applicable, seek payment from all third party  payors
    8  including  governmental  agencies prior to claiming payment from a given
    9  municipality  for  evaluations  conducted  under  the  program  and  for
   10  services rendered to eligible children, provided that, the obligation to
   11  seek  payment  shall not apply to a payment from a third party payor who
   12  is not prohibited from  applying  such  payment,  and  will  apply  such
   13  payment, to an annual or lifetime limit specified in the insured's poli-
   14  cy.
   15    S  2.    Subdivision  1  of  section 2557 of the public health law, as
   16  amended by section 4 of part C of chapter 1 of  the  laws  of  2002,  is
   17  amended to read as follows:
   18    1. The approved costs for an eligible child who receives an evaluation
   19  and early intervention services pursuant to this title shall be a charge
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD11760-09-4
       A. 8195--A                          2
    1  upon  the  municipality wherein the eligible child resides AND THE STATE
    2  or, where the services are covered by the  medical  assistance  program,
    3  upon  the social services district of fiscal responsibility with respect
    4  to those eligible children who are also eligible for medical assistance.
    5  All  approved  costs  shall  be paid in the first instance [and at least
    6  quarterly] WITHIN THIRTY DAYS by the appropriate governing body or offi-
    7  cer of the municipality AND THE STATE upon vouchers presented and audit-
    8  ed in the same manner as the case of other claims  against  the  munici-
    9  pality.  Notwithstanding  the  insurance  law  or regulations thereunder
   10  relating to the permissible exclusion of  payments  for  services  under
   11  governmental  programs,  no  such  exclusion shall apply with respect to
   12  payments made pursuant to this title. Notwithstanding the insurance  law
   13  or any other law or agreement to the contrary, benefits under this title
   14  shall  be considered secondary to any plan of insurance or state govern-
   15  ment benefit program under which an eligible child  may  have  coverage.
   16  Nothing in this section shall increase or enhance coverages provided for
   17  within an insurance contract subject to the provisions of this title.
   18    S 3. Subdivision 5 of section 2557 of the public health law is amended
   19  by adding a new paragraph (d) to read as follows:
   20    (D)  THE  FISCAL  AGENT SHALL, AT LEAST QUARTERLY, CONDUCT A RECONCIL-
   21  IATION OF THIRD PARTY REIMBURSEMENT PURSUANT  TO  SUBDIVISION  THREE  OF
   22  SECTION  TWENTY-FIVE  HUNDRED  FIFTY-NINE  OF  THIS ARTICLE, AND PROVIDE
   23  REIMBURSEMENT IN EQUAL PROPORTION TO THE  STATE  AND  MUNICIPALITY  UPON
   24  VOUCHERS FOR EARLY INTERVENTION SERVICES THAT HAVE BEEN PAID.
   25    S  4.  This  act  shall take effect immediately and shall be deemed to
   26  have been in full force and effect on and after June 1, 2014.