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

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         8195
                              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 -- read once and
         referred to the Committee on Health
       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
   20  upon  the  municipality wherein the eligible child resides AND THE STATE
   21  or, where the services are covered by the  medical  assistance  program,
   22  upon  the social services district of fiscal responsibility with respect
   23  to those eligible children who are also eligible for medical assistance.
   24  All approved costs shall be paid in the first  instance  [and  at  least
   25  quarterly] WITHIN THIRTY DAYS by the appropriate governing body or offi-
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD11760-07-3
       A. 8195                             2
    1  cer of the municipality AND THE STATE upon vouchers presented and audit-
    2  ed  in  the  same manner as the case of other claims against the munici-
    3  pality. Notwithstanding the  insurance  law  or  regulations  thereunder
    4  relating  to  the  permissible  exclusion of payments for services under
    5  governmental programs, no such exclusion shall  apply  with  respect  to
    6  payments  made pursuant to this title. Notwithstanding the insurance law
    7  or any other law or agreement to the contrary, benefits under this title
    8  shall be considered secondary to any plan of insurance or state  govern-
    9  ment  benefit  program  under which an eligible child may have coverage.
   10  Nothing in this section shall increase or enhance coverages provided for
   11  within an insurance contract subject to the provisions of this title.
   12    S 3. Subdivision 5 of section 2557 of the public health law is amended
   13  by adding a new paragraph (d) to read as follows:
   14    (D) THE FISCAL AGENT SHALL, AT LEAST QUARTERLY,  CONDUCT  A  RECONCIL-
   15  IATION  OF  THIRD  PARTY  REIMBURSEMENT PURSUANT TO SUBDIVISION THREE OF
   16  SECTION TWENTY-FIVE HUNDRED FIFTY-NINE  OF  THIS  ARTICLE,  AND  PROVIDE
   17  REIMBURSEMENT  IN  EQUAL  PROPORTION  TO THE STATE AND MUNICIPALITY UPON
   18  VOUCHERS FOR EARLY INTERVENTION SERVICES THAT HAVE BEEN PAID.
   19    S 4. This act shall take effect immediately and  shall  be  deemed  to
   20  have been in full force and effect on and after June 1, 2013.