Bill Text: NY A10679 | 2023-2024 | General Assembly | Introduced

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Bill Title: Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-08-28 - referred to insurance [A10679 Detail]

Download: New_York-2023-A10679-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          10679

                   IN ASSEMBLY

                                     August 28, 2024
                                       ___________

        Introduced  by  COMMITTEE ON RULES -- (at request of M. of A. Hunter) --
          read once and referred to the Committee on Insurance

        AN ACT to amend  the  insurance  law,  in  relation  to  establishing  a
          mandated  window  of  five business days for both Medicaid and private
          insurers to respond to pre-authorization  claims  for  testing  and/or
          treatments made by physicians on behalf of oncology patients

          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 3238  of  the  insurance  law  is
     2  amended by adding a new paragraph 7 to read as follows:
     3    (7)  with  regard  to claims of pre-authorization filed by a physician
     4  with private insurers and/or Medicaid on behalf of an oncology  patient,
     5  it  is  hereby  mandated  that a waiting period of five business days be
     6  established in which an insurer must respond to such a claim. If in such
     7  a case the insurer does not render a decision and notify  the  physician
     8  within  the  period of five business days following the filing of a pre-
     9  authorization claim, the physician deemed responsible for  treating  the
    10  patient  is  authorized to conduct the lifesaving testing, treatment, or
    11  procedure and as such, the insurer  will  be  made  liable  for  payment
    12  covering the prescribed method of care.
    13    § 2. This act shall take effect immediately.





         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15856-01-4