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Who cares
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Sponsors
No co-sponsors yet.
History
- Print number 5015b
- Amend and recommit to insurance
- Print number 5015a
- Amend (t) and recommit to insurance
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Relates to the determination of overpayment recovery amounts for health care providers
In Senate Committee · Rules · Sponsor Charles Lavine
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:S5015B REVISED MEMO 06/17/2014
Title of bill
An act to amend the insurance law, in relation to deter- mination of overpayments to health care providers by extrapolation
Purpose
Requires specific measures to be taken if extrapolation is used to determine if health care providers received overpayments.
Summary of provisions
This bill would amend-section 3224-b of the insurance law to ensure that if extrapolation is used in determining whether health care providers have received overpayments from a health care plan, the health care plan must comply with specific requirements.
Justification
Insurance companies have the ability after performing an audit for a specified period of time, to use a process known as extrapolation in order to seek additional payments from the healthcare provider based on a projection of what they believe the healthcare provider has over- charged, for which no audit was conducted. This legislation allows healthcare companies to continue extrapolation, but gives the healthcare provider "doctors" the ability to determine how the extrapolated numbers were arrived at and allows the final audit to be submitted to an inde- pendent auditor, to determine if the insurance company audit figures were arrived at arbitrarily. This is a due process bill for medical providers.
Legislative history
New bill.
Fiscal implications
None.
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.