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- Referred to health
- Referred to health
Companion bill
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Relates to insurance reimbursement for early intervention services for infants and toddlers with disabilities
In Assembly Committee · Insurance · Sponsor Marc Alessi
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the public health law and the insurance law, in relation to insurance reimbursement for early intervention services for infants and toddlers with disabilities
Purpose/summary of provisions
The intended goal of the legislative proposal is to require that private health insurers reimburse Suffolk County for Early Intervention services and accept the Early Intervention Individual Family Service Plan as documentation of pre-authorization and prior approval services.
Title II-A of Article 25 of the Public Health Law mandates that counties pursue revenue streams, including third party health insurance reimbursement, prior to seeking aid for Early Intervention Program services. The statute was amended in 2002 to assure municipalities facilitated access to such funding; however, receiving reimbursement from private health insurers for Early Intervention services will remain a difficult process unless mandated.
Justification
Private health insurance companies are not processing most reimbursement claims related to delivery of services eligible infants and toddlers with disabilities. Suffolk County has been able to recover only 100 of the costs of services billed to third party insurers. Stronger legislative language would eliminate the large percentage of claims rejection and expedite the reimbursement process.
Fiscal implications for state and local governments
In 2007, Suffolk County billed approximately $12 million to private health insurers and received approximately $1.4 million. Legislative clarification would eliminate denials for "out of network provider" and "not a covered service", and Suffolk County could see significant increases in reimbursement rates from third party insurers, as was the intent of the 2002 statue change.
The State would also benefit from decreased state aid reimbursement to the counties.
Effective date
This act shall take effect immediately
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.