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Who cares
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Sponsors
7 Co-sponsors
28 Multi-sponsors
- Peter Abbate
- Jeffrion Aubry
- Jonathan Bing
- James F. Brennan
- Barbara Clark
- William Colton
- Vivian Cook
- Michael Cusick
- Steven Cymbrowitz
- Steven Englebright
- Sandy Galef
- Deborah Glick
- Carl Heastie
- Earlene Hooper
- Micah Kellner
- Barbara Lifton
- Nettie Mayersohn
- John McEneny
- Joan Millman
- Felix Ortiz
- Crystal Peoples-Stokes
- N. Nick Perry
- Audrey Pheffer
- Jose Rivera
- Annette Robinson
- Robert Sweeney
- Darryl Towns
- Harvey Weisenberg
History
- Referred to health
- Delivered to senate
- Passed assembly
- Amended on third reading 728a
- Ordered to third reading cal.63
- Returned to assembly
- Died in senate
- Referred to health
- Delivered to senate
- Passed assembly
- Advanced to third reading cal.299
- Reported
Show 1 earlier action
- Referred to health
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:A728A
Title of bill
An act to amend the public health law and the insurance law, in relation to notification of an enrollee's designee and the enrollee's health care provider of the initiation of an external appeal and the appeal determination; and to repeal certain provisions of the public health law and the insurance law allowing a health care plan to charge an insured a fee for an appeal
Purpose or general idea of bill
To make modifications to the external appeals process in order to make it more responsive to health care consumers.
Summary of specific provisions
This bill repeals subdivision 3 of section 4910 of the Public Health Law to eliminate the $50 application fee for an external appeal. It also amends section 4914 of the Public Health Law to provide for notification of a patient's designee and health care provider of a utilization review final adverse determination and the rendering of an external appeal determination. Finally, this bill makes the same corresponding changes to sections 4910, 4912 and 4914 of the Insurance Law.
Justification
This legislation is designed to simplify the external appeals application process for patients, and to ensure that the patient's health care provider is involved in the process. This legis- lation would repeal the $50 external appeals application fee, which can serve as a barrier to some patients exerting their right to an appeal under law. In addition. it has been reported that approximately only one-half of the health insurers are actually collecting a fee, which creates an unbalanced situation for patients, depending upon the plan within which they are enrolled. This legislation would remove that barrier and create an equal application of the law.
This bill also makes an important change to the external appeals law to ensure that a patient's designee and health care provider are included in the notification process attendant to the external appeals process.
Prior legislative history
2002:A.10484 - passed the Assembly 2003-04: A.3445 - passed Assembly 2005-06: A.2210 - passed Assembly 2007-08: A.3789 - passed Assembly 2009: A.728 - advanced to 3rd reading
Fiscal implications
None
Effective date
This act shall take effect 180 days after it has become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.