What's happening
This bill amends the New York state medical indemnity fund law, repealing certain provisions and clarifying qualifying health care costs.
Why it matters
Narrows the definition of qualifying health care costs. , clarifying that costs may “incidentally benefit” other household members as long as they primarily benefit the patient—potentially reducing disputes over allowable expenses and making it clearer what can be covered.
Eliminates specific procedures for appealing denials. and removes requirements for consumer and stakeholder workgroups, which may limit beneficiaries’ avenues for challenging fund decisions and reduce stakeholder input into the fund’s operation.
Requires a financial solvency report on the fund. , directing the superintendent of financial services to assess and report on the fund’s financial health and future viability, which could inform potential policy changes or funding needs and affect those relying on the fund.
Alters and sets expiration dates for certain amendments. , creating time-limited changes to aspects of the law, which could lead to future legislative reviews and uncertainty for beneficiaries regarding the permanence of these provisions.
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Change Medical Fund Rules
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Signed chap.4
- Delivered to governor
- Returned to assembly
- Passed senateVote 61–0
- 3rd reading cal.19
- Substituted for S986
- Referred to rules
- Delivered to senate
- Passed assembly
- Ordered to third reading rules cal.9
- Rules report cal.9
- Reported
Show 3 earlier actions
- Reported referred to rules
- Reported referred to codes
- Referred to health
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.
Change Medical Fund Rules
Senate Floor Calendar · Sponsor Kemp Hannon
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
378
2017-2018 Regular Sessions
IN ASSEMBLY
January 5, 2017
Introduced by M. of A. ABINANTI -- read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to the state medical indemnity fund; to amend a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, in relation to the effectiveness thereof; and to repeal subdivisions 2-a and 7-a of section 2999-j and section 2999-k of the public health law, relating to requests for denials of claims and denials of requests for prior authorizations and consumer and stakeholder workgroups
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivisions 2-a and 7-a of section 2999-j of the public health law, as added by a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as proposed in legislative bills numbers S.7873-B and A.9835-B, are REPEALED.
§ 2. Paragraph (c) of subdivision 2 of section 2999-j of the public health law, as added by a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as proposed in legislative bills numbers S.7873-B and A.9835-B, is amended to read as follows:
(c) such regulations shall not prohibit qualifying health care costs on the grounds that the qualifying health care cost [is not limited to the direct need of the patient and] may incidentally benefit other members of the household, provided that whether the qualifying health care cost primarily benefits the patient may be considered.
§ 3. Subdivision 3 of section 2999-h of the public health law, as amended by a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06718-04-7
A. 378 2
proposed in legislative bills numbers S.7873-B and A.9835-B, is amended to read as follows:
3. "Qualifying health care costs" means the future medical, hospital, surgical, nursing, dental, rehabilitation, habilitation, respite, custodial, durable medical equipment, home modifications, assistive technology, vehicle modifications, transportation for purposes of health care related appointments, prescription and non-prescription medications, and other health care costs actually incurred for services rendered to and supplies utilized by qualified plaintiffs, which are necessary to meet their health care needs, [including providing therapeutic benefit,] as determined by their treating physicians, physician assistants, or nurse practitioners and as otherwise defined by the commissioner in regulation.
§ 4. Section 2999-k of the public health law, as added by a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as proposed in legislative bills numbers S.7873-B and A.9835-B, is REPEALED.
§ 5. On or before April 1, 2017, the superintendent of financial services shall issue a report to the governor and the legislature addressing the financial condition of the state medical indemnity fund, the future solvency of such fund, and any issues relating to the operation of such fund that the superintendent, in his or her sole discretion, elects to include in the report. In preparing the report, the superintendent may consult with qualified plaintiffs, representatives of qualified plaintiffs, and physicians, advocates, and other interested parties.
§ 6. Section 5 of a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as proposed in legislative bills numbers S.7873-B and A.9835-B, is amended to read as follows:
§ 5. This act shall take effect on the forty-fifth day after it shall have become a law, provided that the amendments to subdivision 4 of section 2999-j of the public health law made by section two of this act shall take effect on June 30, 2017 and shall expire and be deemed repealed December 31, 2019.
§ 7. This act shall take effect immediately; provided, however, that sections one, two, three and four of this act shall take effect on the same date and in the same manner as a chapter of the laws of 2016, amending the public health law relating to payments from the New York state medical indemnity fund, as proposed in legislative bills numbers S.7873-B and A.9835-B, takes effect.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.