Bill Text: NY S03155 | 2017-2018 | General Assembly | Introduced

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Bill Title: Relates to insurance coverage of early intervention services.

Spectrum: Partisan Bill (Republican 4-0)

Status: (Introduced - Dead) 2018-01-03 - REFERRED TO INSURANCE [S03155 Detail]

Download: New_York-2017-S03155-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          3155
                               2017-2018 Regular Sessions
                    IN SENATE
                                    January 20, 2017
                                       ___________
        Introduced  by  Sens.  GRIFFO, LATIMER, MURPHY -- read twice and ordered
          printed, and when printed to be committed to the Committee  on  Insur-
          ance
        AN  ACT  to  amend  the  insurance law, in relation to coverage of early
          intervention services
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Subsection (a) of section 3235-a of the insurance law, as
     2  added by section 3 of part C of chapter  1  of  the  laws  of  2002,  is
     3  amended  and  two  new  subsections  (e)  and  (f)  are added to read as
     4  follows:
     5    (a) No policy of accident and health  insurance,  including  contracts
     6  issued  pursuant  to  article forty-three of this chapter, shall exclude
     7  coverage for otherwise covered services [solely on the  basis  that  the
     8  services  constitute  early  intervention  program  services]  that  are
     9  provided under title two-A of article twenty-five of the  public  health
    10  law.
    11    (e)  Where  a  service  provided  to an insured under the early inter-
    12  vention program is a covered  service  under  the  insurer's  policy  or
    13  contract, the individualized family services plan, upon certification by
    14  the  early  intervention  official,  as  defined  in section twenty-five
    15  hundred forty-one of the public health law, or such official's designee,
    16  shall be deemed to  meet  any  precertification,  preauthorization,  and
    17  medical  necessity  requirements imposed on benefits under the policy or
    18  contract; provided, however, that the provider shall  remove  or  redact
    19  any   information  contained  in  the  insured's  individualized  family
    20  services plan that is not required by the insurer for payment  purposes.
    21  Payment  for  a  service  covered  under  the policy or contract that is
    22  provided under the early intervention program shall be at  rates  estab-
    23  lished  by the commissioner of health for such service pursuant to regu-
    24  lations.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05164-01-7
        S. 3155                             2
     1    (f) No insurer, including a health maintenance organization  issued  a
     2  certificate  of  authority under article forty-four of the public health
     3  law and a corporation organized under article forty-three of this  chap-
     4  ter,  shall  deny  payment  of  an early intervention claim based on the
     5  following:
     6    (1) the location where services are provided;
     7    (2)  the  duration  of  the  child's condition and/or that the child's
     8  condition is not amenable to significant improvement  within  a  certain
     9  period of time as specified in the policy; or
    10    (3)  that  the  provider of services is not a network or participating
    11  provider.
    12    § 2. This act shall take effect immediately.