Requires health insurance companies to provide health care providers with list of services that require preauthorization from the health insurance company

BILL NUMBER:A8592

Title of bill

An act to amend the insurance law, in relation to requiring health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company; and to amend the public health law, in relation to pre-authorized services

Purpose or general idea of bill

This legislation would require health insurance companies to provide participating physicians and health care providers with a list of treatments and services that require preauthor- ization so that health care providers can anticipate seeking authori- zation for such treatments and deliver care more efficiently,

Summary of specific provisions

The insurance law is amended by adding a new section 4242, which stipulates that every health insurance company shall be required to provide participating physicians and health care providers with an updated list of health care treatments and services that require reauthorization from the insurance company.

Justification

Poor management and inefficiency in the health care industry has a negative effect on patient care. Before a physician can authorize a test or assessment for a physician they must get preauthori- zation from a health care provider- a process that can take days. Very often early diagnosis is imperative for patient care. If the circum- stances are grave, patients may not receive the care they need. By requiring insurers to provide a list of treatments and services that require preauthorization, health care providers can anticipate having to seek authorization for such treatments and take the appropriate steps.

Prior legislative history

None

FISCAL IMPLICATIONS;.u off;: None

Effective date

This act shall take effect on the sixtieth day after it shall have become law.