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History
- Referred to insurance
- Referred to insurance
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to notice by health maintenance organizations that a request for coverage of a particular treatment is denied
Purpose
This bill would amend the Insurance Law to require health maintenance organizations to furnish an insured client, upon denial of coverage for a requested treatment or procedure, the clinical standards used in that determination.
Summary of provisions
Section 1 -- Amends the Insurance Law by adding a new Section 2601-a which directs health maintenance organizations to inform an insured customer of the clinical standards used when denying a medical procedure or treatment.
Section 2 -- Effective date.
Justification
Insured individuals seeking care for a medical condition are sometimes denied coverage for a particular procedure or treatment because it is deemed medically necessary by an insurer. Currently, an insurer is under no obligation to inform the insured about the standards used when denying coverage for a medical treatment or procedure. This bill would direct insurers to inform patients why the requested coverage was denied.
Legislative history
S.4027 of 2007-2008 S.4497 of 2005-2006 S.853 of 2001-2002 S.6504 of 1999-2000
Fiscal implications
None.
Effective date
Thirty days after it shall have become a law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.