New York A 1936: Relates to prior authorization and payments from the medical indemnity fund

Bill Text

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A01936 Summary:

BILL NOA01936 

&nbsp

SAME ASSAME AS S05710

&nbsp

SPONSORPaulin

&nbsp

COSPNSRSayegh, Lucas, McDonald, Slater, Burdick, Levenberg, Shimsky, Griffin

&nbsp

MLTSPNSR

&nbsp

Amd §§2999-j & 2999-i, Pub Health L

&nbsp

Requires any regulation that mandates prior authorization to establish a mechanism for submission of requests for prior authorization by health care providers directly to the medical indemnity fund; requires the medical indemnity fund administrator to notify qualified plaintiffs which costs are qualifying health care costs to be paid from the fund and which are not within a reasonably prompt period of time.

Go to top A01936 Actions:

BILL NOA01936 

&nbsp

01/14/2025referred to health

01/07/2026referred to health

Go to topA01936 Committee&nbspVotes:

Go to topA01936 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA01936 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 1936

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 14, 2025
 ___________

 Introduced by M. of A. PAULIN, SAYEGH, LUCAS -- read once and referred
 to the Committee on Health

 AN ACT to amend the public health law, in relation to prior authori-
 zation and payments from the medical indemnity fund

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Paragraph (b) of subdivision 2 of section 2999-j of the
 2 public health law, as amended by section 3 of part K of chapter 57 of
 3 the laws of 2019, is amended and a new paragraph (b-1) is added to read
 4 as follows:
 5 (b) if any prior authorization is required by such regulation, the
 6 regulation shall require that requests for prior authorization be proc-
 7 essed within a reasonably prompt period of time and shall identify a
 8 process for prompt administrative review of any denial of a request for
 9 prior authorization; [and]
 10 (b-1) if any prior authorization is required by such regulation, the
 11 regulation shall require establishing a mechanism for submission of
 12 requests for prior authorization by health care providers directly to
 13 the fund; and
 14 § 2. Paragraph (b) of subdivision 8 of section 2999-j of the public
 15 health law, as added by section 52 of part H of chapter 59 of the laws
 16 of 2011, is amended and a new paragraph (c) is added to read as follows:
 17 (b) thereupon certify to the commissioner of taxation and finance
 18 those costs that have been determined to be qualifying health care costs
 19 to be paid from the fund[.]; and
 20 (c) notify the qualified plaintiff which of such costs are qualifying
 21 health care costs to be paid from the fund along with which of such
 22 costs are not qualifying health care costs to be paid from the fund in a
 23 reasonably prompt period of time.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD04765-01-5

 A. 1936 2

 1 § 3. Subdivision 5 and paragraph (a) of subdivision 6 of section
 2 2999-i of the public health law, as amended by section 2 of part K of
 3 chapter 57 of the laws of 2019, are amended to read as follows:
 4 5. For the state fiscal year beginning April first, two thousand elev-
 5 en and ending March thirty-first, two thousand twelve, the state fiscal
 6 year beginning April first, two thousand twelve and ending March thir-
 7 ty-first, two thousand thirteen, and the state fiscal year beginning
 8 April first, two thousand thirteen and ending March thirty-first, two
 9 thousand fourteen, the superintendent of financial services shall cause
 10 to be deposited into the fund for each such fiscal year the amount
 11 appropriated for such purpose. Beginning April first, two thousand four-
 12 teen and annually thereafter, the superintendent of financial services
 13 or the commissioner, whoever is administering the fund for the applica-
 14 ble period shall cause to be deposited into the fund, subject to avail-
 15 able appropriations, an amount equal to the difference between the
 16 amount appropriated to the fund in the preceding fiscal year[,]. Begin-
 17 ning April first, two thousand twenty-six, the commissioner or the
 18 administrator of the fund for the applicable period shall cause to be